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Laparoscopic splenectomy in pediatric age: long-term follow-up

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Introduction: In the last century, with the advancement of the diagnostic procedures, hematologic disorders in pediatric age group have been increased dramatically. In parallel with this increase, splenectomy procedures have alsobeen popularized with different techniques andsurgical outcomes. Laparoscopic splenectomy (LS) in the pediatric age group is generally accepted as a technically demanding procedure, which needs experience. The purpose of this study is to present the long-term follow-up results of a case series of children who underwent LS for a variety of hematologic disorders, evaluate possible complications and outcomes.Population and methods: All patients who were admitted to the clinic and who were scheduled for LS from 2005 to 2016 were considered for this study. The study parameters were grouped in four categories including socio-demographic data, preoperative evaluation, clinical follow-up and complications.
Results: There were 24 male (48.9%) and 25 (51.1%) female patients. The median age and body weight for the study group was 12 years and 35 kg. Most common indications for LS were thalassemia (13; 26.5%) and hereditary spherocytosis (12; 24.4%). As a technical standpoint, 2 patients (4%) underwent single- port LS surgery. The mean time for LS surgeries was found as 80 minutes. The total intra- operative complication rate was 4% (2/57). The mean time for hospital stay was 5 days. Mean follow-up period was 6.4 years (range: 6 months-16 years). There was no long-term complication. Bilirubin levels and need for bloodtransfusion significantly decreased in the longterm follow-up period (p <0.05).
Conclusions: LS is a powerful tool in the hands of an experienced surgeon. It’s a safe andeffective procedure in children with hematologicdisorders resulting in shorter length of stay and lower complication rates.

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