Pediatric laparoscopic splenectomy |
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Authors: | A Park B T Heniford A Hebra P Fitzgerald |
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Institution: | (1) Department of Surgery, General Surgery Division, University of Kentucky Chandler Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA, US;(2) Carolinas Medical Center, Charlotte, NC, USA, US;(3) Medical University of South Carolina, Charleston, SC, USA, US;(4) McMaster University, Hamilton, Ontario, Canada, CA |
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Abstract: | Background: Lateral laparoscopic splenectomy in adults, first reported in 1991, was begun with children in 1993.
Methods: The authors reviewed records of 59 patients 2 to 17 years old who underwent laparoscopic splenectomy by the lateral approach
between 1994 and 1998 at four medical centers. Patients received prophylactic penicillin or vaccinations preoperatively.
Results: Of the 59 patients, 51 required splenectomy for one of the following conditions: idiopathic thrombocytopenic purpura, hereditary
spherocytosis, or sickle-cell disease. Splenomegaly was found in 86% of the patients, and ten accessory spleens were resected.
No deaths or infection occurred, and only three patients had perioperative complications: acute chest crisis, small diaphragmatic
injury, and intraoperative hemorrhage. One operation was converted to a minilaparatomy because of difficulty with specimen
extraction.
Conclusions: Pediatric laparoscopic splenectomy is safe and effective, resulting in little blood loss, rapid recovery, and a good cosmetic
outcome.
Received: 12 February 1999/Accepted: 24 September 1999/Online publication: 8 May 2000 |
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Keywords: | : Laparoscopy — Pediatric — Purpura — Sickle-cell disease — Spherocytosis — Splenectomy |
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