The lateral approach for open splenectomy
Background: Laparoscopic splenectomy (LS) has been used increasingly to treat children with hematologic disorders and has been reported to have advantages over open splenectomy performed through a standard vertical or subcostal incision. The authors perform open splenectomy (OS) through a lateral, m...
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Veröffentlicht in: | Journal of pediatric surgery 1998-07, Vol.33 (7), p.1153-1157 |
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container_title | Journal of pediatric surgery |
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creator | Geiger, J.D Dinh, V.V Teitelbaum, D.H Lelli, J.L Harmon, C.M Hirschl, R.B Polley, T.Z Drongowski, B.A Coran, A.G |
description | Background:
Laparoscopic splenectomy (LS) has been used increasingly to treat children with hematologic disorders and has been reported to have advantages over open splenectomy performed through a standard vertical or subcostal incision. The authors perform open splenectomy (OS) through a lateral, muscle-splitting approach, and believe their approach is more reasonable in comparison with LS.
Methods:
Thirty-nine consecutive open splenectomies performed between 1991 and 1995 were reviewed retrospectively and compared with recent reports of LS. The series included 24 boys and 15 girls with an average age of 9 years and average weight of 37.5 kg. Indications included immune thrombocytopenic purpura (n = 20), hereditary spherocytosis (n = 18), and sickle cell anemia (n = 1). The operation was performed with the child in the lateral decubitus position through a left upper abdominal muscle-splitting incision (off the 11th rib), sparing the rectus muscle.
Results:
All 39 cases were completed without intraoperative complications with an average surgical time of 98.0 minutes (range, 30 to 302). The average surgical blood loss was 89 mL (range, 10 to 300). The children started feeding an average of 1.2 days (range, 0 to 4) postoperatively, were on a regular diet at an average of 2.0 days (range, 1 to 6) postoperatively, and had an average length of stay of 2.7 days (range, 1 to 6). There was no mortality or morbidity.
Conclusions:
Open lateral splenectomy is performed with shorter surgical times, less blood loss, an excellent cosmetic result, no complications, and a length of stay comparable to any of the published series on laparoscopic splenectomy in children. This approach provides a reasonable basis for comparison with laparoscopic splenectomy. |
doi_str_mv | 10.1016/S0022-3468(98)90550-4 |
format | Article |
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Laparoscopic splenectomy (LS) has been used increasingly to treat children with hematologic disorders and has been reported to have advantages over open splenectomy performed through a standard vertical or subcostal incision. The authors perform open splenectomy (OS) through a lateral, muscle-splitting approach, and believe their approach is more reasonable in comparison with LS.
Methods:
Thirty-nine consecutive open splenectomies performed between 1991 and 1995 were reviewed retrospectively and compared with recent reports of LS. The series included 24 boys and 15 girls with an average age of 9 years and average weight of 37.5 kg. Indications included immune thrombocytopenic purpura (n = 20), hereditary spherocytosis (n = 18), and sickle cell anemia (n = 1). The operation was performed with the child in the lateral decubitus position through a left upper abdominal muscle-splitting incision (off the 11th rib), sparing the rectus muscle.
Results:
All 39 cases were completed without intraoperative complications with an average surgical time of 98.0 minutes (range, 30 to 302). The average surgical blood loss was 89 mL (range, 10 to 300). The children started feeding an average of 1.2 days (range, 0 to 4) postoperatively, were on a regular diet at an average of 2.0 days (range, 1 to 6) postoperatively, and had an average length of stay of 2.7 days (range, 1 to 6). There was no mortality or morbidity.
Conclusions:
Open lateral splenectomy is performed with shorter surgical times, less blood loss, an excellent cosmetic result, no complications, and a length of stay comparable to any of the published series on laparoscopic splenectomy in children. This approach provides a reasonable basis for comparison with laparoscopic splenectomy.</description><identifier>ISSN: 0022-3468</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1016/S0022-3468(98)90550-4</identifier><identifier>PMID: 9694113</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Blood Loss, Surgical ; Child ; Child, Preschool ; Endoscopy ; Female ; Humans ; Length of Stay ; Male ; Organ Size ; Retrospective Studies ; Splenectomy - methods ; Time Factors</subject><ispartof>Journal of pediatric surgery, 1998-07, Vol.33 (7), p.1153-1157</ispartof><rights>1998</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c360t-d6b4687d29c7cc6deffd9e9ec6c9389e9b0f5c31ea9bfd9f7f2fa8f92107f00e3</citedby><cites>FETCH-LOGICAL-c360t-d6b4687d29c7cc6deffd9e9ec6c9389e9b0f5c31ea9bfd9f7f2fa8f92107f00e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-3468(98)90550-4$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9694113$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Geiger, J.D</creatorcontrib><creatorcontrib>Dinh, V.V</creatorcontrib><creatorcontrib>Teitelbaum, D.H</creatorcontrib><creatorcontrib>Lelli, J.L</creatorcontrib><creatorcontrib>Harmon, C.M</creatorcontrib><creatorcontrib>Hirschl, R.B</creatorcontrib><creatorcontrib>Polley, T.Z</creatorcontrib><creatorcontrib>Drongowski, B.A</creatorcontrib><creatorcontrib>Coran, A.G</creatorcontrib><title>The lateral approach for open splenectomy</title><title>Journal of pediatric surgery</title><addtitle>J Pediatr Surg</addtitle><description>Background:
Laparoscopic splenectomy (LS) has been used increasingly to treat children with hematologic disorders and has been reported to have advantages over open splenectomy performed through a standard vertical or subcostal incision. The authors perform open splenectomy (OS) through a lateral, muscle-splitting approach, and believe their approach is more reasonable in comparison with LS.
Methods:
Thirty-nine consecutive open splenectomies performed between 1991 and 1995 were reviewed retrospectively and compared with recent reports of LS. The series included 24 boys and 15 girls with an average age of 9 years and average weight of 37.5 kg. Indications included immune thrombocytopenic purpura (n = 20), hereditary spherocytosis (n = 18), and sickle cell anemia (n = 1). The operation was performed with the child in the lateral decubitus position through a left upper abdominal muscle-splitting incision (off the 11th rib), sparing the rectus muscle.
Results:
All 39 cases were completed without intraoperative complications with an average surgical time of 98.0 minutes (range, 30 to 302). The average surgical blood loss was 89 mL (range, 10 to 300). The children started feeding an average of 1.2 days (range, 0 to 4) postoperatively, were on a regular diet at an average of 2.0 days (range, 1 to 6) postoperatively, and had an average length of stay of 2.7 days (range, 1 to 6). There was no mortality or morbidity.
Conclusions:
Open lateral splenectomy is performed with shorter surgical times, less blood loss, an excellent cosmetic result, no complications, and a length of stay comparable to any of the published series on laparoscopic splenectomy in children. This approach provides a reasonable basis for comparison with laparoscopic splenectomy.</description><subject>Adolescent</subject><subject>Blood Loss, Surgical</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Organ Size</subject><subject>Retrospective Studies</subject><subject>Splenectomy - methods</subject><subject>Time Factors</subject><issn>0022-3468</issn><issn>1531-5037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkF9LwzAUxYMoc04_gtAncQ_Vm6ZpmyeR4T8Y-OB8DmlywyptU5NO2Lc3c2OvwoVccs7Nyf0Rck3hjgIt7j8AsixleVHdimougHNI8xMypZzRlAMrT8n0aDknFyF8AcRroBMyEYXIKWVTMl-tMWnViF61iRoG75ReJ9b5xA3YJ2FosUc9um57Sc6sagNeHc4Z-Xx-Wi1e0-X7y9vicZlqVsCYmqKOeaXJhC61LgxaawQK1IUWrIpdDZZrRlGJOiq2tJlVlRUZhdICIJuRm_278S_fGwyj7JqgsW1Vj24TZAXA8xxENPK9UXsXgkcrB990ym8lBblDJP8Qyd3-UsTaIZJ5nLs-BGzqDs1x6sAk6g97HeOWPw16GXSDvUbT-IhCGtf8k_ALZ8F19Q</recordid><startdate>19980701</startdate><enddate>19980701</enddate><creator>Geiger, J.D</creator><creator>Dinh, V.V</creator><creator>Teitelbaum, D.H</creator><creator>Lelli, J.L</creator><creator>Harmon, C.M</creator><creator>Hirschl, R.B</creator><creator>Polley, T.Z</creator><creator>Drongowski, B.A</creator><creator>Coran, A.G</creator><general>Elsevier Inc</general><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>7X8</scope></search><sort><creationdate>19980701</creationdate><title>The lateral approach for open splenectomy</title><author>Geiger, J.D ; Dinh, V.V ; Teitelbaum, D.H ; Lelli, J.L ; Harmon, C.M ; Hirschl, R.B ; Polley, T.Z ; Drongowski, B.A ; Coran, A.G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c360t-d6b4687d29c7cc6deffd9e9ec6c9389e9b0f5c31ea9bfd9f7f2fa8f92107f00e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adolescent</topic><topic>Blood Loss, Surgical</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Organ Size</topic><topic>Retrospective Studies</topic><topic>Splenectomy - methods</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Geiger, J.D</creatorcontrib><creatorcontrib>Dinh, V.V</creatorcontrib><creatorcontrib>Teitelbaum, D.H</creatorcontrib><creatorcontrib>Lelli, J.L</creatorcontrib><creatorcontrib>Harmon, C.M</creatorcontrib><creatorcontrib>Hirschl, R.B</creatorcontrib><creatorcontrib>Polley, T.Z</creatorcontrib><creatorcontrib>Drongowski, B.A</creatorcontrib><creatorcontrib>Coran, A.G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Geiger, J.D</au><au>Dinh, V.V</au><au>Teitelbaum, D.H</au><au>Lelli, J.L</au><au>Harmon, C.M</au><au>Hirschl, R.B</au><au>Polley, T.Z</au><au>Drongowski, B.A</au><au>Coran, A.G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The lateral approach for open splenectomy</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>1998-07-01</date><risdate>1998</risdate><volume>33</volume><issue>7</issue><spage>1153</spage><epage>1157</epage><pages>1153-1157</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><abstract>Background:
Laparoscopic splenectomy (LS) has been used increasingly to treat children with hematologic disorders and has been reported to have advantages over open splenectomy performed through a standard vertical or subcostal incision. The authors perform open splenectomy (OS) through a lateral, muscle-splitting approach, and believe their approach is more reasonable in comparison with LS.
Methods:
Thirty-nine consecutive open splenectomies performed between 1991 and 1995 were reviewed retrospectively and compared with recent reports of LS. The series included 24 boys and 15 girls with an average age of 9 years and average weight of 37.5 kg. Indications included immune thrombocytopenic purpura (n = 20), hereditary spherocytosis (n = 18), and sickle cell anemia (n = 1). The operation was performed with the child in the lateral decubitus position through a left upper abdominal muscle-splitting incision (off the 11th rib), sparing the rectus muscle.
Results:
All 39 cases were completed without intraoperative complications with an average surgical time of 98.0 minutes (range, 30 to 302). The average surgical blood loss was 89 mL (range, 10 to 300). The children started feeding an average of 1.2 days (range, 0 to 4) postoperatively, were on a regular diet at an average of 2.0 days (range, 1 to 6) postoperatively, and had an average length of stay of 2.7 days (range, 1 to 6). There was no mortality or morbidity.
Conclusions:
Open lateral splenectomy is performed with shorter surgical times, less blood loss, an excellent cosmetic result, no complications, and a length of stay comparable to any of the published series on laparoscopic splenectomy in children. This approach provides a reasonable basis for comparison with laparoscopic splenectomy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>9694113</pmid><doi>10.1016/S0022-3468(98)90550-4</doi><tpages>5</tpages></addata></record> |
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subjects | Adolescent Blood Loss, Surgical Child Child, Preschool Endoscopy Female Humans Length of Stay Male Organ Size Retrospective Studies Splenectomy - methods Time Factors |
title | The lateral approach for open splenectomy |
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