Laparoscopic Splenectomy in Children with Hematological Disorders: Preliminary Experience at the Children's Hospital of New Orleans
Minimally invasive surgery has recently gained acceptance as the surgical approach of choice for a variety of surgical disorders in children. Although traditional open surgery is still regarded as the standard approach for a splenectomy in children when necessary for hematologic disorders a few case...
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| Veröffentlicht in: | The American surgeon 2000-12, Vol.66 (12), p.1168-1170 |
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| container_title | The American surgeon |
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| creator | Liu, Donald C. Meyers, Michael O. Hill, Charles B. Loe, William A. |
| description | Minimally invasive surgery has recently gained acceptance as the surgical approach of choice for a variety of surgical disorders in children. Although traditional open surgery is still regarded as the standard approach for a splenectomy in children when necessary for hematologic disorders a few cases of successful laparoscopic splenectomy (LS) have been reported. We present our initial 11 cases of LS in children assessing surgical outcome. Eleven patients ages 2 through 15 years underwent LS between June of 1996 and July of 1999 at the Children's Hospital of New Orleans. Indications for surgery included idiopathic thrombocytopenic purpura, congenital spherocytosis, and hemolytic anemia. In all patients the diameter of the spleen was less than 15 cm. Surgical outcome was assessed according to the following parameters: operative time, postoperative length of stay, postoperative morbidity, and cosmetic results. Data were accumulated on the basis of retrospective chart review. LS was completed in all 11 patients. Postoperative morbidity was minimal and the median postoperative stay was 2.4 days (range 1–5). Mean operative time was 3 hours and 10 minutes (range 1.5–7 hours) with the last six procedures completed in an average of just over 2 hours. Intravenous analgesia was discontinued in |
| doi_str_mv | 10.1177/000313480006601216 |
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Although traditional open surgery is still regarded as the standard approach for a splenectomy in children when necessary for hematologic disorders a few cases of successful laparoscopic splenectomy (LS) have been reported. We present our initial 11 cases of LS in children assessing surgical outcome. Eleven patients ages 2 through 15 years underwent LS between June of 1996 and July of 1999 at the Children's Hospital of New Orleans. Indications for surgery included idiopathic thrombocytopenic purpura, congenital spherocytosis, and hemolytic anemia. In all patients the diameter of the spleen was less than 15 cm. Surgical outcome was assessed according to the following parameters: operative time, postoperative length of stay, postoperative morbidity, and cosmetic results. Data were accumulated on the basis of retrospective chart review. LS was completed in all 11 patients. Postoperative morbidity was minimal and the median postoperative stay was 2.4 days (range 1–5). Mean operative time was 3 hours and 10 minutes (range 1.5–7 hours) with the last six procedures completed in an average of just over 2 hours. Intravenous analgesia was discontinued in <48 hours in all patients. Cosmetic results were judged excellent in all cases. We conclude that LS was safe in children with certain hematologic disorders. Adequate selection of patients, appropriate preoperative preparation of patients, meticulous surgical technique, and careful postoperative care were key factors in obtaining the same long-term results as with open surgery.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/000313480006601216</identifier><identifier>PMID: 11149592</identifier><identifier>CODEN: AMSUAW</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Biological and medical sciences ; Blood ; Child ; Child, Preschool ; Children & youth ; Hematologic Diseases - complications ; Hospitals, Pediatric ; Humans ; Hypersplenism - diagnosis ; Hypersplenism - etiology ; Hypersplenism - surgery ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Liver, biliary tract, pancreas, portal circulation, spleen ; Louisiana - epidemiology ; Medical disorders ; Medical sciences ; Morbidity ; Patient Selection ; Pediatrics ; Postoperative Care - methods ; Preoperative Care - methods ; Retrospective Studies ; Spleen ; Splenectomy - adverse effects ; Splenectomy - instrumentation ; Splenectomy - methods ; Splenomegaly - diagnosis ; Splenomegaly - etiology ; Splenomegaly - surgery ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Time Factors ; Treatment Outcome</subject><ispartof>The American surgeon, 2000-12, Vol.66 (12), p.1168-1170</ispartof><rights>2000 Southeastern Surgical Congress</rights><rights>2001 INIST-CNRS</rights><rights>Copyright The Southeastern Surgical Congress Dec 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c394t-e9cd5ca706540731107fb970264acb7988a70f2613dada3ca86cf03a342d41073</citedby><cites>FETCH-LOGICAL-c394t-e9cd5ca706540731107fb970264acb7988a70f2613dada3ca86cf03a342d41073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/000313480006601216$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/000313480006601216$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,21819,23930,23931,25140,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=842653$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11149592$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Donald C.</creatorcontrib><creatorcontrib>Meyers, Michael O.</creatorcontrib><creatorcontrib>Hill, Charles B.</creatorcontrib><creatorcontrib>Loe, William A.</creatorcontrib><title>Laparoscopic Splenectomy in Children with Hematological Disorders: Preliminary Experience at the Children's Hospital of New Orleans</title><title>The American surgeon</title><addtitle>Am Surg</addtitle><description>Minimally invasive surgery has recently gained acceptance as the surgical approach of choice for a variety of surgical disorders in children. Although traditional open surgery is still regarded as the standard approach for a splenectomy in children when necessary for hematologic disorders a few cases of successful laparoscopic splenectomy (LS) have been reported. We present our initial 11 cases of LS in children assessing surgical outcome. Eleven patients ages 2 through 15 years underwent LS between June of 1996 and July of 1999 at the Children's Hospital of New Orleans. Indications for surgery included idiopathic thrombocytopenic purpura, congenital spherocytosis, and hemolytic anemia. In all patients the diameter of the spleen was less than 15 cm. Surgical outcome was assessed according to the following parameters: operative time, postoperative length of stay, postoperative morbidity, and cosmetic results. Data were accumulated on the basis of retrospective chart review. LS was completed in all 11 patients. Postoperative morbidity was minimal and the median postoperative stay was 2.4 days (range 1–5). Mean operative time was 3 hours and 10 minutes (range 1.5–7 hours) with the last six procedures completed in an average of just over 2 hours. Intravenous analgesia was discontinued in <48 hours in all patients. Cosmetic results were judged excellent in all cases. We conclude that LS was safe in children with certain hematologic disorders. Adequate selection of patients, appropriate preoperative preparation of patients, meticulous surgical technique, and careful postoperative care were key factors in obtaining the same long-term results as with open surgery.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Hematologic Diseases - complications</subject><subject>Hospitals, Pediatric</subject><subject>Humans</subject><subject>Hypersplenism - diagnosis</subject><subject>Hypersplenism - etiology</subject><subject>Hypersplenism - surgery</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Louisiana - epidemiology</subject><subject>Medical disorders</subject><subject>Medical sciences</subject><subject>Morbidity</subject><subject>Patient Selection</subject><subject>Pediatrics</subject><subject>Postoperative Care - methods</subject><subject>Preoperative Care - methods</subject><subject>Retrospective Studies</subject><subject>Spleen</subject><subject>Splenectomy - adverse effects</subject><subject>Splenectomy - instrumentation</subject><subject>Splenectomy - methods</subject><subject>Splenomegaly - diagnosis</subject><subject>Splenomegaly - etiology</subject><subject>Splenomegaly - surgery</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kV9rFDEUxYModlv9Aj5IUKhPY3PzZzLxTdbqCosV1Ochm7nTTZlJxmSW2me_uFl2aUHBp8slv3NyOYeQF8DeAmh9wRgTIGRTZl0z4FA_IgtQSlWm4eIxWeyBak-ckNOcb8oqawVPyQkASKMMX5DfazvZFLOLk3f02zRgQDfH8Y76QJdbP3QJA73185aucLRzHOK1d3agH3yOqcOU39GvCQc_-mDTHb38NWHyGBxSO9N5i_cmbzJdxTz5uYhjT7_gLb1KA9qQn5EnvR0yPj_OM_Lj4-X35apaX336vHy_rpwwcq7QuE45q1mtJNMCgOl-YzTjtbRuo03TlLee1yA621nhbFO7ngkrJO9kgcUZOT_4Tin-3GGe29Fnh8NgA8ZdbjVXYLSBAr76C7yJuxTKbS0H3jAFcu_GD5Ar8eWEfTslP5YMWmDtvp_2336K6OXRebcZsXuQHAspwOsjYHOJuU82OJ_vuUbyWolCXRyobK_x4bj_fPwHZkmkrQ</recordid><startdate>20001201</startdate><enddate>20001201</enddate><creator>Liu, Donald C.</creator><creator>Meyers, Michael O.</creator><creator>Hill, Charles B.</creator><creator>Loe, William A.</creator><general>SAGE Publications</general><general>Southeastern Surgical Congress</general><general>SAGE PUBLICATIONS, INC</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20001201</creationdate><title>Laparoscopic Splenectomy in Children with Hematological Disorders: Preliminary Experience at the Children's Hospital of New Orleans</title><author>Liu, Donald C. ; Meyers, Michael O. ; Hill, Charles B. ; Loe, William A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c394t-e9cd5ca706540731107fb970264acb7988a70f2613dada3ca86cf03a342d41073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Hematologic Diseases - complications</topic><topic>Hospitals, Pediatric</topic><topic>Humans</topic><topic>Hypersplenism - diagnosis</topic><topic>Hypersplenism - etiology</topic><topic>Hypersplenism - surgery</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Louisiana - epidemiology</topic><topic>Medical disorders</topic><topic>Medical sciences</topic><topic>Morbidity</topic><topic>Patient Selection</topic><topic>Pediatrics</topic><topic>Postoperative Care - methods</topic><topic>Preoperative Care - methods</topic><topic>Retrospective Studies</topic><topic>Spleen</topic><topic>Splenectomy - adverse effects</topic><topic>Splenectomy - instrumentation</topic><topic>Splenectomy - methods</topic><topic>Splenomegaly - diagnosis</topic><topic>Splenomegaly - etiology</topic><topic>Splenomegaly - surgery</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Donald C.</creatorcontrib><creatorcontrib>Meyers, Michael O.</creatorcontrib><creatorcontrib>Hill, Charles B.</creatorcontrib><creatorcontrib>Loe, William A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Donald C.</au><au>Meyers, Michael O.</au><au>Hill, Charles B.</au><au>Loe, William A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic Splenectomy in Children with Hematological Disorders: Preliminary Experience at the Children's Hospital of New Orleans</atitle><jtitle>The American surgeon</jtitle><addtitle>Am Surg</addtitle><date>2000-12-01</date><risdate>2000</risdate><volume>66</volume><issue>12</issue><spage>1168</spage><epage>1170</epage><pages>1168-1170</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><coden>AMSUAW</coden><abstract>Minimally invasive surgery has recently gained acceptance as the surgical approach of choice for a variety of surgical disorders in children. Although traditional open surgery is still regarded as the standard approach for a splenectomy in children when necessary for hematologic disorders a few cases of successful laparoscopic splenectomy (LS) have been reported. We present our initial 11 cases of LS in children assessing surgical outcome. Eleven patients ages 2 through 15 years underwent LS between June of 1996 and July of 1999 at the Children's Hospital of New Orleans. Indications for surgery included idiopathic thrombocytopenic purpura, congenital spherocytosis, and hemolytic anemia. In all patients the diameter of the spleen was less than 15 cm. Surgical outcome was assessed according to the following parameters: operative time, postoperative length of stay, postoperative morbidity, and cosmetic results. Data were accumulated on the basis of retrospective chart review. LS was completed in all 11 patients. Postoperative morbidity was minimal and the median postoperative stay was 2.4 days (range 1–5). Mean operative time was 3 hours and 10 minutes (range 1.5–7 hours) with the last six procedures completed in an average of just over 2 hours. Intravenous analgesia was discontinued in <48 hours in all patients. Cosmetic results were judged excellent in all cases. We conclude that LS was safe in children with certain hematologic disorders. Adequate selection of patients, appropriate preoperative preparation of patients, meticulous surgical technique, and careful postoperative care were key factors in obtaining the same long-term results as with open surgery.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>11149592</pmid><doi>10.1177/000313480006601216</doi><tpages>3</tpages></addata></record> |
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| subjects | Adolescent Biological and medical sciences Blood Child Child, Preschool Children & youth Hematologic Diseases - complications Hospitals, Pediatric Humans Hypersplenism - diagnosis Hypersplenism - etiology Hypersplenism - surgery Laparoscopy - adverse effects Laparoscopy - methods Length of Stay - statistics & numerical data Liver, biliary tract, pancreas, portal circulation, spleen Louisiana - epidemiology Medical disorders Medical sciences Morbidity Patient Selection Pediatrics Postoperative Care - methods Preoperative Care - methods Retrospective Studies Spleen Splenectomy - adverse effects Splenectomy - instrumentation Splenectomy - methods Splenomegaly - diagnosis Splenomegaly - etiology Splenomegaly - surgery Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Time Factors Treatment Outcome |
| title | Laparoscopic Splenectomy in Children with Hematological Disorders: Preliminary Experience at the Children's Hospital of New Orleans |
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