       Document 0051
 DOCN  M9630051
 TI    Laparoscopic splenectomy. Technique and results in a series of 27 cases.
 DT    9603
 AU    Emmermann A; Zornig C; Peiper M; Weh HJ; Broelsch CE; Chirurgische
       Klinik, Universitatskrankenhaus Eppendorf, Hamburg,; Germany.
 SO    Surg Endosc. 1995 Aug;9(8):924-7. Unique Identifier : AIDSLINE
       MED/96016690
 AB    Between early 1992 and December 1994, laparoscopic splenectomy was
       performed in 27 patients with idiopathic thrombocytopenia (ITP),
       hairy-cell leucemia, HIV, or Hodgkin's disease. In all cases medical
       treatment, especially cortisone therapy, failed. In Hodgkin's disease
       the splenectomy was combined with liver biopsies and dissection of
       parailiacal, paraaortic, and mesenteric lymph nodes for abdominal
       staging. The operation was performed using four trocars; the splenic
       vessels were divided by a linear stapler. In general the spleen was
       removed in a bag through a slightly enlarged trocar incision or after
       morcellation. Three patients needed a small laparotomy for the removal
       (laparoscopic assisted). In a recent case of Hodgkin's disease the
       intact spleen was removed via posterior colpotomy. In 22 of 27 cases
       (81%) the operation was finished laparoscopically. Five times a
       conversion to conventional laparotomy was necessary because of bleeding
       of enlarged lymph nodes at the hilum. Wound infections occurred in two
       cases. In one patient with ITP the platelet count did not improve and
       continuous blood loss led to relaparotomy at the 1st postoperative day.
       No surgical bleeding was found. All patients tolerated a fluid diet at
       the 1st postoperative day and hospitalization time was 4.4 days (range
       3-14). Regarding the low complication rate and the advantages of a
       smaller abdominal trauma in the postoperative period, the laparoscopic
       approach for elective splenectomy and laparoscopic abdominal staging has
       a substantial benefit for the patients.
 DE    Adolescence  Adult  Aged  Female  Hodgkin's Disease/SURGERY  Human
       Leukemia, Hairy Cell/SURGERY  Male  Middle Age  Splenectomy/*METHODS
       Surgery, Laparoscopic/*METHODS  Thrombocytopenia/SURGERY  CLINICAL TRIAL
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

