Objective:
Surgical splenectomy is one of the most frequent operations carried out by surgeons specializing in trauma and hematologic diseases. The techniques for splenectomy are open surgical splenectomy, hand-assisted laparoscopic splenectomy (HALS), laparoscopic splenectomy (LS) and singleincision laparoscopic splenectomy (SILS). In this study we aim to discuss our experiences and evaluate the optimum surgical technique for splenectomy.
Methods:
A retrospective analysis of 74 patients who had undergone surgical splenectomy was carried out. 65 patients who had undergone open splenectomy and 9 patients who had undergone laparoscopic splenectomy were compared with regard to operation indications, splenic size, age, sexuality, operation time, peroperative blood loss, postoperative complications and length of stay in hospital.
Results:
Of the 74 patients who had undergone splenectomy, 50 had hematologic diseases and 9 had hydatid cysts. Of the patients who had undergone open splenectomy, the splenic size was no larger than 57 cm. In those patients that had undergone laparoscopic splenectomy, the splenic size was no larger than 21 cm. The average age of open splenectomy patients was 42.6 years (with the youngest being 9 years old and the eldest 83). The average age of laparoscopic surgery patients was 41.2 years (with the youngest being 17 and the eldest 54). The female: male ratio in open splenectomy patients was 32:33, and in laparoscopic splenectomy patients was 5:4. Of the parameters comparing preoperative, peroperative, and postoperative bleeding, the peroperative bleeding parameters were found to be statistically significant. Peroperative blood loss in open splenectomy was found to be too great. Other parameters were not found to be statistically significant.
Conclusion:
The past experience of surgeons and the splenic size should direct our approach to surgical splenectomy. In the case of hematologic diseases and malignant splenic masses, open surgical splenectomy is a necessary approach.
Keywords: Splenic diseases, splenectomy indication, choosing surgical techniques