Document Detail


Laparoscopic splenectomy for lymphoproliferative disease.
MedLine Citation:
PMID:  14691699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Elective laparoscopic splenectomy (LS) achieves excellent results for benign hematologic diseases. The role of LS for hematologic malignancies is harder to define owing to associated splenomegaly and patient disease that may alter outcome. METHODS: Retrospective review of single institution experience 1996 through 2002. To limit variability of disease processes, only patients with immune thrombocytopenic purpura (ITP) and lymphoproliferative disease (LPD) were studied. RESULTS: A total of 211 LS have been performed, including 73 for LPD and 86 for ITP. Patients with LPD were significantly older, 61 vs 46 years p<0.001; male, 45 (62%) vs 33 (38%), p<0.001; and larger splenic weight, 680 vs 162 g, p<0.001. Fifty-nine patients (81%) with LPD were operated with standard LS with a conversion rate of 15%. Hand-assisted LS was performed in 14 patients (19%), and three were converted to open. Compared to ITP, patients with LPD had longer operative time, 148 vs 126 min, p<0001, and higher blood loss, 200 vs 100 cc, p = 0.004. There was one mortality (0.6%), and morbidity occurred in six patients (8%) with LPD and seven (8%) with ITP. The median length of stay was 3 days for LPD and 2 days for ITP, p = 0.03. Forty-six patients were principally operated for a diagnosis, and 27 (60%) were found to have lymphoma. CONCLUSIONS: LS can be performed safely in patients with LPD, and when used judiciously with hand-assisted techniques can be performed with low conversion and morbidity rates. Splenectomy plays an important role in establishing the diagnosis of lymphoma in LPD.
Authors:
R M Walsh; F Brody; N Brown
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Review     Date:  2003-12-29
Journal Detail:
Title:  Surgical endoscopy     Volume:  18     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-25     Completed Date:  2004-08-19     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  272-5     Citation Subset:  IM    
Affiliation:
Department of General Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Databases, Factual
Female
Humans
Laparoscopy / methods*,  statistics & numerical data
Length of Stay
Lymphoma, Non-Hodgkin / complications,  diagnosis,  surgery
Lymphoproliferative Disorders / complications,  surgery*
Male
Middle Aged
Postoperative Complications
Purpura, Thrombocytopenic, Idiopathic / complications,  surgery*
Retrospective Studies
Splenectomy / methods*,  statistics & numerical data
Splenomegaly / etiology,  surgery*
Surgical Procedures, Elective
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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