Central surgical associationPerioperative outcomes of laparoscopic versus open splenectomy: A meta-analysis with an emphasis on complications☆
Section snippets
Study selection
A Medline search was done for all English-language reports that used the terms splenectomy or LS from January of 1991 through December of 2002. Surgical series that described outcomes were reviewed in detail, and the references were examined for additional articles that were not identified by the Medline search. Studies were excluded if any of the following parameters were present: fewer than 20 cases, splenectomy for trauma or incidentally, data not reported on an intention-to-treat basis, or
Patient population
A total of 51 reports met the criteria for inclusion in this analysis. Twenty-six studies compared OS to LS (paired), and 25 studies reported only on LS (unpaired). Of the 2940 patients in those studies, 2119 patients (72.1%) underwent LS, and 821 patients (27.9%) underwent OS. Of the patients who underwent LS, 41.3% were in studies that reported paired groups, with the remaining 58.7% of LS patients in series that described only the laparoscopic approach. Most studies were retrospective, with
Discussion
For LS to be regarded as the preferred approach to splenectomy, it should be associated not only with less postoperative pain and a faster recovery but also should have a lower complication rate. Data from some institutional series have suggested that LS is associated with fewer complications,16., 17., 18. but other series have failed to show this.19., 20. Three separate descriptive reviews attempted to address the issue of complications after LS,21., 22., 23. and 2 reviews concluded that LS is
Acknowledgements
We thank Paul Thompson, PhD, from the Division of Biostatistics at Washington University, for assistance with the statistical analysis.
References (25)
- et al.
A learning curve for laparoscopic splenectomy at an academic institution
J Surg Res
(1999) Laparoscopic and open cholecystectomy in New York state: mortality, complications, and choice of procedure
Surgery
(1999)- et al.
Results of laparoscopic splenectomy for immune thrombocytopenic purpura
Am J Surg
(1999) - et al.
A case-controlled study of laparoscopic splenectomy
Am J Surg
(1997) - et al.
Splenectomy by the laparoscopic approach: report of a case
Presse Medicale
(1991) - et al.
Laparoscopic splenectomy
Surg Endosc
(2002) - et al.
Laparoscopic splenectomy: outcome and efficacy in 103 consecutive patients
Ann Surg
(1998) - et al.
Laparoscopic splenectomy for idiopathic thrombocytopenia purpura (ITP): long-term follow-up data
Surg Endosc
(2003) - et al.
Laparoscopic splenectomy
Surg Endosc
(1995) - et al.
Laparoscopic splenectomy has become the gold standard in children
Am Surg
(2002)
Laparoscopic splenectomy for ITP: the gold standard
Surg Endosc
Laparoscopic splenectomy in patients with hematologic diseases
Ann Surg
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Presented at the 60th Annual Meeting of the Central Surgical Association, Toronto, Ontario, Canada, March 20-22, 2003.