Technical aspects of laparoscopic splenectomy in children

Schleef, J.; Morcate, J. J.; Steinau, G.; Ott, Bernhard; Willital, Giinther-Heinrich

doi:10.1016/s0022-3468(97)90720-x

Cited by 12 publications

(3 citation statements)

References 2 publications

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“…Laparoscopic splenectomy has become an important option in early 1990s [13][14][15][16][17][18][19][20][21]; because it offers the advantages of minimally invasive surgery to these anemic, trombocytopenic or immune suppressed patients. There are many reports in the literature, which compare open and laparoscopic splenectomy [22][23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Life-Threatening Massive Thromboembolism After Laparoscopic Splenectomy in an Idiopathic Thrombocytopenic Patient

Uz¹,

Duzenci²,

Atlı³

et al. 2014

G.J. Hematol. Blood Trans.

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A life-threatening massive thromboembolism is reported that developed after laparoscopic splenectomy in a 57-year-old female with idiopathic thrombocytopenic purpura (ITP). Although asymptomatic, she underwent splenectomy because of poor response to steroids and intravenous (IV) gamma globulin. Thirteen days after splenectomy, she suffered portal and mesenteric emboli, followed by pulmoner emboli and left popliteal thrombophlebitis. Extensive workup for hypercoagulable states was negative. Low molecular weight heparin (LMWH) was initiated at a suboptimal dose because of thrombocytopenia. During follow-up, her platelet count increased gradually. Whenever the platelet count had remained stable at > 50 x 10 9 /L, she received full dose of LMWH treatment. Over the next 38 days, her pain resolved, she tolerated a full diet, and sent home. Follow-up imaging studies demonstrated a recanalized portal vein and totally resolved pulmonary arteries. We thought that, consumption of platelets in the massive thromboembolism sites including portal, mesenteric and pulmoner vascular beds had resulted in deep thrombocytopenia, which improved gradually with anticoagulant therapy.

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Section: Discussionmentioning

confidence: 99%

Life-Threatening Massive Thromboembolism After Laparoscopic Splenectomy in an Idiopathic Thrombocytopenic Patient

Uz¹,

Duzenci²,

Atlı³

et al. 2014

G.J. Hematol. Blood Trans.

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“…The approach usually described [4,10] is the posterior approach on a patient in right lateral decubitus. Division of the vessels is carried out with the endo-GIA stapler [12].…”

Section: Discussionmentioning

confidence: 99%

Pediatric laparoscopic splenectomy: benefits of the anterior approach

et al. 2004

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With this technique consisting in first elective arterial and secondary venal ligature, we preserved blood splenic sequestration and pancreatic tail lesion. The procedure is safer. For us, considering the low complication rate for this type of patient, and the advantages of a small abdominal trauma in the postoperative period, laparoscopy with anterior approach for elective splenectomy and eventual cholecystectomy in hematologic disorders is the best technique.

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“…Laparoscopic splenectomy is becoming popular and many series have been reported (2,3,4,5,6,7,8,9) after it was first reported in 1991 1. To gain acceptance, a surgical procedure first has to meet certain criteria as technical feasibility, low morbidity, low mortality, patient comfort, acceptable operation time, cost and therapeutic effectiveness comperable to the alternative procedure.…”

Section: Discussionmentioning

confidence: 99%