Background
Laparoscopic splenectomy has gained popularity in the management of children with benign hematological disease who required splenectomy. We aim to report the outcome after standardization of techniques in laparoscopic splenectomy.
Materials and methods
A retrospective study was conducted in which all children with benign hematological disease underwent laparoscopic splenectomy in our institute from 2003 to 2017. The demographics and outcomes before (Group 1) and after (Group 2) standardization of techniques were compared. The laparoscopic techniques were standardized in Group 2. They all underwent multiport laparoscopic splenectomy and the splenic pedicles were divided by bipolar sealing device (LigaSure). In Group 1, splenectomy could be performed by single port or multiple ports approach. The splenic pedicles could be divided by endovascular stapler or LigaSure.
Results
Group 1 included 14 children who underwent splenectomy from 2003 to 2010 and Group 2 included 9 children who were operated from 2011 to 2017. The demographics were comparable between the two groups. Group 2 was associated with lower complication (0 vs. 5, p = 0.043), shorter operative time in splenectomy (146 min vs. 173 min, p = 0.056) and shorter mean hospital stay (3.8 days vs. 7.1 days, p < 0.0001).
Conclusions
Superior outcomes including lower complication rates and shorter hospital stay were observed after standardization of surgical techniques in laparoscopic splenectomy in children using multiple ports and LigaSure.