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4 - Our laparoscopic splenectomy experience in children
M. Özgür Kuzdan, Çetin A. Karadağ, Ali İhsan Dokucu, Ali Bülbül
Aim: Laparoscopic splenectomy (LS) currently is preferential method of splenectomy in many centers. Because LS has many advantages, it is common. Thus we present our experience of LS. We compared with literature in terms of operative time, operative bleeding, conversion rate, requirement of analgesic, hospital stay, postoperative complication rate, operative cost.
Material ve method: Our study include patients undergone LS between June and September in 2006.
Results: LS was performed in 25 children (8 girls and 17 boys) with mean age 8.9 years (age 1-6). Indications of LS were kronik ITP (10), herediter sferositoz (6), beta talesemi (8), otoimmün hemolitik anemi (1). Length of spleen were found to be 80-192 mm (mean spleen length 127.8 mm) in our patients. Three trocars were used in 16 patients, but four trocars were used in 9 patients. LigaSure Vessel Sealing System were used for achieving a safe vascular control, in two patients who had the biggest spleen size conversion to open procedure was necessary when spleen was removed. Because dissection could not completed in one of those, elevated level of pCO2 in arterial blood in other of those. The spleen was removed through the umbilical trocar by using a retrieval bag in other patients. Mean operative time was 154 min (45-240 min). No complication developed except one patient who suffered pleural effusion. Mean hospital stay was 4 days (2-12 days) and mean operative cost was found 2736 TL (1890 $).
Conclusion: LS can be performed safely even in clinic of pediatric surgery where LS has just been initiated. LS is preferred since advantages of LS are less postoperative pain, shorter of hospital stay and better cosmetic results.
Keywords: Children, laparoscopic splenectomy
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