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Gulhane Med J. 2009; 51(4): 239-243


Our open and laparoscopic surgical results in elective splenectomy

Ali Harlak1, İlker Sücüllü2, Sezai Demirbaş1, Taner Yiğit1, Yavuz Özdemir2, Ali İlker Filiz2, Öner Menteş1, Zafer Kılbaş1, Gökhan Yağcı1.

Abstract
In this study it was aimed to evaluate the comparative results of different surgical techniques used in elective splenectomy on the basis of our particular experience and patient series. The medical records of patients undergoing elective splenectomy in a 8-year period were investigated retrospectively. The patients were divided into open (n=87), laparoscopic (n=17) and hand-assisted laparoscopic splenectomy (n=11) groups, and these groups were compared with respect to demographic data, body mass index, indication for splenectomy, size of the spleen, duration of operation, rate of conversion to open surgery, and major and minor complications after surgery. It was detected that hand-assisted laparoscopic splenectomy was performed in larger spleens. Only two of the 11 patients had idiopathic trombocytopenic purpura in the hand-assisted laparoscopic splenectomy group, whereas the major cause of splenectomy in other groups was idiopathic trombocytopenic purpura. Conversion to the open surgery was seen in one patient in each of the two laparoscopic groups, and relaparotomy was performed in one patient in each of the open surgery and hand-assisted laparoscopy groups. There were 5 minor surgical complications in the open surgery group, and one in each of the other groups. In conclusion hand-assisted laparoscopic splenectomy which was more preferred in patients with large sized spleens has shortened the operation time. Laparoscopic splenectomy and hand-assisted laparoscopic splenectomy are safe surgical procedures with acceptable complication rates.

Key words: Surgical technique, hand-assisted, laparoscopic, splenectomy



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