Is expertise in pediatric surgery necessary to perform laparoscopic splenectomy in children? An experience from a department of general surgery.

摘要: Splenectomy is frequently required in children for various hematologic pathologic findings. Because of progress minimally invasive techniques, laparoscopic splenectomy (LS) has become feasible. The objective this report to present a monocentric experience and evaluate the efficacy complications observed after splenic procedures department general surgery. 57 consecutive LSs have been performed pediatric population between January 2000 October 2010. There were 33 females 24 males with median age 12 years (range 4–17). Indications were: hereditary spherocytosis 38 cases, idiopathic thrombocytopenic purpura 10, sickle cell disease (SCD) 6, thrombotic 2 non-hodgkin lymphoma 1 case. Patients operated on using right semilateral position, employing Atlas Ligasure vessel sealing system 49 cases (86%) Harmonic Scalpel + EndoGIA 8. In patients (42.1%), cholecystectomy was associated. Two conversion open (3.5%). three minilaparotomy spleen removal (5.2%). Accessory spleens identified Complications (8.8%) included bleeding (two), abdominal collection (one) pleural effusion (two). no mortality. Average operative time 128 min 80–220). length stay 3 days 2–7). Mean blood loss 80 ml 30–500) transfusion rate 1.7% (one patient). Laparoscopic surgery safe, reliable effective disorders associated minimal morbidity, zero mortality, short stay. shortened loss. On basis results, we consider approach gold standard treatment these even