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Laparoscopic Splenectomy: Has It Become the Standard Surgical Approach in Pediatric Patients?
- Source :
-
The Journal of surgical research [J Surg Res] 2019 Aug; Vol. 240, pp. 109-114. Date of Electronic Publication: 2019 Mar 26. - Publication Year :
- 2019
-
Abstract
- Background: Splenectomy is often required in the pediatric population as part of the treatment of hematologic disorders and can be performed laparoscopically or open. We evaluated the comparative effectiveness of laparoscopic (LS) and open (OS) splenectomies using the American College of Surgeons National Surgical Quality Improvement Program Pediatric (NSQIP-P) data set.<br />Methods: The NSQIP-P data set was used to identify children who underwent elective splenectomy between January 2012 and December 2016. Thirty-day outcomes between OS and LS, and LS alone and concurrent LS and cholecystectomy were compared using univariate and multivariate analysis.<br />Results: Most of the splenectomies (91%) were performed laparoscopically. There was no difference in overall complications between OS (n = 60) and LS (n = 613), although OS had a higher risk of perioperative transfusion (OR 3.19, 95% CI 1.52-6.69). LS was associated with a shorter median hospital length of stay (2 versus 4 d, P < 0.001) and similar mean operative times compared to OS (120 versus 133 min, P = 0.559). There was no difference in outcomes of children undergoing LS versus LS and concurrent cholecystectomy (n = 129).<br />Conclusions: LS has become the standard approach for elective splenectomies in the pediatric population and has minimal morbidity, and when indicated, concurrent cholecystectomies do not increase the risk of complications.<br />Levels of Evidence: III.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Child
Child, Preschool
Cholecystectomy adverse effects
Cholecystectomy methods
Datasets as Topic
Elective Surgical Procedures adverse effects
Elective Surgical Procedures methods
Female
Humans
Laparoscopy adverse effects
Laparoscopy methods
Length of Stay statistics & numerical data
Male
Operative Time
Postoperative Complications etiology
Retrospective Studies
Splenectomy adverse effects
Splenectomy methods
Treatment Outcome
Elective Surgical Procedures trends
Hematologic Diseases surgery
Laparoscopy trends
Postoperative Complications epidemiology
Splenectomy trends
Subjects
Details
- Language :
- English
- ISSN :
- 1095-8673
- Volume :
- 240
- Database :
- MEDLINE
- Journal :
- The Journal of surgical research
- Publication Type :
- Academic Journal
- Accession number :
- 30925411
- Full Text :
- https://doi.org/10.1016/j.jss.2019.02.045