Comparison of laparoscopic and open splenectomy in children with hematologic disorders

R. A. Farah, Z. R. Rogers, W. R. Thompson, B. A. Hicks, P. C. Guzzetta, G. R. Buchanan

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58 Citations (Scopus)

Abstract

Objective: To compare laparoscopic and traditional open splenectomy in children with nonmalignant hematologic disorders. Study design: Retrospective review of 36 consecutive nonrandomized splenectomies (16 laparoscopic and 20 open) performed for hematologic disorders at a single pediatric institution during the past 3 years. The two-sided Mann-Whitney U test for nonparametric variables was used for statistical analysis. Results: An open procedure was performed on 20 patients (mean age, 9.7 years), five of whom had a concomitant cholecystectomy. A laparoscopic splenectomy was performed on 16 children (mean age, 10.3 years), seven of whom had a concomitant cholecystectomy. The mean anesthesia and operative times were longer in the laparoscopic than in the open group (p < 0.001). However, the mean number of hours of postoperative analgesia was less in the laparoscopic group (p < 0.005). Patients who had laparoscopic splenectomy were also discharged home earlier (p < 0.01) and resumed a regular diet sooner. Mean operating room charges were higher in the laparoscopic group (p < 0.001), but total hospitalization costs were not significantly different. Postoperative complication rates were similar. The hematologic response was comparable. Conclusions: Laparoscopic splenectomy is feasible and safe in children with hematologic disorders. Although it currently requires more operative time than the open approach, it is superior with regard to duration of postoperative analgesia, duration of hospital stay, and recovery of bowel function.

Original languageEnglish (US)
Pages (from-to)41-46
Number of pages6
JournalJournal of Pediatrics
Volume131
Issue number1 I
DOIs
StatePublished - 1997

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Splenectomy
Cholecystectomy
Operative Time
Analgesia
Recovery of Function
Operating Rooms
Nonparametric Statistics
Length of Stay
Hospitalization
Anesthesia
Retrospective Studies
Pediatrics
Diet
Costs and Cost Analysis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Comparison of laparoscopic and open splenectomy in children with hematologic disorders. / Farah, R. A.; Rogers, Z. R.; Thompson, W. R.; Hicks, B. A.; Guzzetta, P. C.; Buchanan, G. R.

In: Journal of Pediatrics, Vol. 131, No. 1 I, 1997, p. 41-46.

Research output: Contribution to journalArticle

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AU - Farah, R. A.

AU - Rogers, Z. R.

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AU - Guzzetta, P. C.

AU - Buchanan, G. R.

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N2 - Objective: To compare laparoscopic and traditional open splenectomy in children with nonmalignant hematologic disorders. Study design: Retrospective review of 36 consecutive nonrandomized splenectomies (16 laparoscopic and 20 open) performed for hematologic disorders at a single pediatric institution during the past 3 years. The two-sided Mann-Whitney U test for nonparametric variables was used for statistical analysis. Results: An open procedure was performed on 20 patients (mean age, 9.7 years), five of whom had a concomitant cholecystectomy. A laparoscopic splenectomy was performed on 16 children (mean age, 10.3 years), seven of whom had a concomitant cholecystectomy. The mean anesthesia and operative times were longer in the laparoscopic than in the open group (p < 0.001). However, the mean number of hours of postoperative analgesia was less in the laparoscopic group (p < 0.005). Patients who had laparoscopic splenectomy were also discharged home earlier (p < 0.01) and resumed a regular diet sooner. Mean operating room charges were higher in the laparoscopic group (p < 0.001), but total hospitalization costs were not significantly different. Postoperative complication rates were similar. The hematologic response was comparable. Conclusions: Laparoscopic splenectomy is feasible and safe in children with hematologic disorders. Although it currently requires more operative time than the open approach, it is superior with regard to duration of postoperative analgesia, duration of hospital stay, and recovery of bowel function.

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