Abstract
| Lingua originale | English |
|---|---|
| pagine (da-a) | 527-531 |
| Numero di pagine | 5 |
| Rivista | Surgical Endoscopy |
| Volume | 21 |
| Stato di pubblicazione | Published - 2007 |
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All Science Journal Classification (ASJC) codes
- Surgery
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Italian multicentric survey on laparoscopic spleen surgery in the pediatric population. / Li Voti, Giuseppe; Scalisi; Pini Prato; Garzi; Porreca; Riccipetitoni, Giovanna; Cheli; Jasonni, Vincenzo; Mattioli, Girolamo; Esposito, Ciro; Rizzo; Mastroianni; Avanzini, Stefano; Buluggiu; Boeri.
In: Surgical Endoscopy, Vol. 21, 2007, pag. 527-531.Risultato della ricerca: Article
}
TY - JOUR
T1 - Italian multicentric survey on laparoscopic spleen surgery in the pediatric population
AU - Li Voti, Giuseppe
AU - Scalisi, null
AU - Pini Prato, null
AU - Garzi, null
AU - Porreca, null
AU - Riccipetitoni, Giovanna
AU - Cheli, null
AU - Jasonni, Vincenzo
AU - Mattioli, Girolamo
AU - Esposito, Ciro
AU - Rizzo, null
AU - Mastroianni, null
AU - Avanzini, Stefano
AU - Buluggiu, null
AU - Boeri, null
PY - 2007
Y1 - 2007
N2 - Abstract Background: Some technical aspects of laparoscopic spleen surgery still are debated, although efforts have been made to standardize them. The position of the patient, the approach to the spleen, vessel identification and division, and spleen extraction can vary from center to center. Methods: This retrospective muticentric study led by the Societa` Italiana di Videochirurgia Infantile (SIVI) examined indications, surgical details, and complications of laparoscopic spleen surgery in the pediatric population during a 5-year period. Results: The study period from January 1999 to December 2003 (5 years) involved nine centers and included 85 patients with a mean age of 10 years (range, 2– 17 years). Hypersplenism or severe hemolysis in cases of hematologic disorders represented the most important indications. More than 90% of the patients underwent total laparoscopic splenectomy. Specific technical details from each center were collected. Intraoperative complications occurred in 19% of the patients (hemorrhage in 8% and technical problems in 14%), and 6% of the patients required conversion to the open approach. No deaths occurred, and no reoperations were required. Postoperative complications were experienced by 2% of the patients. Conclusion: Laparoscopic spleen surgery is safe, reliable, and effective in the pediatric population. On the basis of the results, some technical details for laparoscopic spleen surgery can be suggested. The patient is preferably kept supine or lateral, approaching the spleen anteriorly. Moreover, the ilar vessels should be identified selectively and individually, with initial artery division performed to achieve spleen shrinking. Any hemostatic device proved to be effective in experienced hands. Once freed, the spleen is preferably extracted via a suprapubic cosmetic transverse incision (faster, easier, and safer), although a bag can be used. Finally, the size of the spleen does not represent a contraindication for a trained and experienced surgeon. Nevertheless, this parameter must be considered
AB - Abstract Background: Some technical aspects of laparoscopic spleen surgery still are debated, although efforts have been made to standardize them. The position of the patient, the approach to the spleen, vessel identification and division, and spleen extraction can vary from center to center. Methods: This retrospective muticentric study led by the Societa` Italiana di Videochirurgia Infantile (SIVI) examined indications, surgical details, and complications of laparoscopic spleen surgery in the pediatric population during a 5-year period. Results: The study period from January 1999 to December 2003 (5 years) involved nine centers and included 85 patients with a mean age of 10 years (range, 2– 17 years). Hypersplenism or severe hemolysis in cases of hematologic disorders represented the most important indications. More than 90% of the patients underwent total laparoscopic splenectomy. Specific technical details from each center were collected. Intraoperative complications occurred in 19% of the patients (hemorrhage in 8% and technical problems in 14%), and 6% of the patients required conversion to the open approach. No deaths occurred, and no reoperations were required. Postoperative complications were experienced by 2% of the patients. Conclusion: Laparoscopic spleen surgery is safe, reliable, and effective in the pediatric population. On the basis of the results, some technical details for laparoscopic spleen surgery can be suggested. The patient is preferably kept supine or lateral, approaching the spleen anteriorly. Moreover, the ilar vessels should be identified selectively and individually, with initial artery division performed to achieve spleen shrinking. Any hemostatic device proved to be effective in experienced hands. Once freed, the spleen is preferably extracted via a suprapubic cosmetic transverse incision (faster, easier, and safer), although a bag can be used. Finally, the size of the spleen does not represent a contraindication for a trained and experienced surgeon. Nevertheless, this parameter must be considered
KW - Complications — Fenestration — Laparoscopic splenectomy — Multicentric survey — Spleen —technical details
UR - http://hdl.handle.net/10447/61446
M3 - Article
VL - 21
SP - 527
EP - 531
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
ER -