J Minim Invasive Surg 2006; 9(1): 1-4
Published online June 30, 2006
© The Korean Society of Endo-Laparoscopic & Robotic Surgery
김성엽·장진영·한성식·박윤찬1·김선회·박용현
서울대학교 의과대학 외과학교실, 1단국대학교 의과대학 외과학교실
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Recently, the indication of the laparoscopic splenectomy is expanding. It was traditionally limited to the patients without splenomegaly, mainly idiopathic thrombocytopenic purpura, however it's application expanding to even those with splenomegaly such as hereditay spherocytosis, autoimmune hemolytic anemia and malignant hematologic disease. The aim of this study is to compare the clinical results reflected from the patients who underwent laparoscopic splenectomy with those who underwent open splenectomy. Methods: Between January 1998 to March 2004, consecutive 66 patients were underwent splenectomy in Seoul National University Hospital. Demographic findings and clinical outcomes were compared between the laparoscopic splenectomy (n=33) and open splenectomy (n=33) groups. Results: The patients who underwent the laparoscopic splenectomy had earlier diet start (3.5⁑1.5 versus 4.5⁑1.5 days, p<0.05) and shorter postoperative hospital stay (7.2⁑6.3 versus 10.8⁑3.2 days, p<0.05) and shorter duration ofpostoperative analgesics injection (1.6⁑1.1 versus 4.0⁑2.6 days, p<0.05 ) than those who underwent open splenectomy. The operative time, estimated blood loss, and complication rate for the two groups were similar. The size of spleen was larger in the group of patients who underwent laparoscopic splenectomy (292.5⁑255.6 ml) than those who open splenectomy (1,135.4⁑1,277.9 ml)(p<0.05 ), but there were some patients who underwent laparoscopic splenectomy with severe splenomegaly (627, 544, 1,264 ml). Conclusion: The laparoscopic splenectomy has several advantage such as earlier diet start, shorter postoperative hospital stay and less postoperative pain. With the accumulation of laparoscopic surgery cases and advances in instrument, limitation of technique to splenomegaly has been overcome.
Keywords Splenectomy, Laparoscopy, Treatment outcome
J Minim Invasive Surg 2006; 9(1): 1-4
Published online June 30, 2006
Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.
김성엽·장진영·한성식·박윤찬1·김선회·박용현
서울대학교 의과대학 외과학교실, 1단국대학교 의과대학 외과학교실
Seong-Yeop Kim, M.D., Jin-Young Jang, M.D., Sung-Sik Han, M.D., Youn-Chan Park, M.D.1, Sun-Whe Kim, M.D., Yong-Hyun Park, M.D.
Department of Surgery, Seoul National University College of Medicine, Seoul, 1Department of Surgery, Dankook University College of Medicine, Cheonan, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Recently, the indication of the laparoscopic splenectomy is expanding. It was traditionally limited to the patients without splenomegaly, mainly idiopathic thrombocytopenic purpura, however it's application expanding to even those with splenomegaly such as hereditay spherocytosis, autoimmune hemolytic anemia and malignant hematologic disease. The aim of this study is to compare the clinical results reflected from the patients who underwent laparoscopic splenectomy with those who underwent open splenectomy. Methods: Between January 1998 to March 2004, consecutive 66 patients were underwent splenectomy in Seoul National University Hospital. Demographic findings and clinical outcomes were compared between the laparoscopic splenectomy (n=33) and open splenectomy (n=33) groups. Results: The patients who underwent the laparoscopic splenectomy had earlier diet start (3.5⁑1.5 versus 4.5⁑1.5 days, p<0.05) and shorter postoperative hospital stay (7.2⁑6.3 versus 10.8⁑3.2 days, p<0.05) and shorter duration ofpostoperative analgesics injection (1.6⁑1.1 versus 4.0⁑2.6 days, p<0.05 ) than those who underwent open splenectomy. The operative time, estimated blood loss, and complication rate for the two groups were similar. The size of spleen was larger in the group of patients who underwent laparoscopic splenectomy (292.5⁑255.6 ml) than those who open splenectomy (1,135.4⁑1,277.9 ml)(p<0.05 ), but there were some patients who underwent laparoscopic splenectomy with severe splenomegaly (627, 544, 1,264 ml). Conclusion: The laparoscopic splenectomy has several advantage such as earlier diet start, shorter postoperative hospital stay and less postoperative pain. With the accumulation of laparoscopic surgery cases and advances in instrument, limitation of technique to splenomegaly has been overcome.
Keywords: Splenectomy, Laparoscopy, Treatment outcome
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
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