caa a22 4500 475779045 CHVBK 20180406123639.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1007/s004640000149 doi (NATIONALLICENCE)springer-10.1007/s004640000149 Impact of hematological diagnosis on early and late outcome after laparoscopic splenectomyrid="" [Elektronische Daten] An analysis of 111 cases id=""Presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), San Antonio, Texas, USA, 24&ndash;28 March 1999 [M. Trias, E. M. Targarona, J. J. Espert, G. Cerdan, E. Bombuy, O. Vidal, V. Artigas] Background: Laparoscopic splenectomy (LS) is now regarded as the treatment of choice for autoimmune thrombopenia (ITP). However, there have been few reports describing the application of LS to other splenic diseases, such as malignant entities and conditions associated with splenomegaly. Hematological diseases have specific clinical features that can influence immediate outcome after LS. Although the long-term effects of LS are unknown, a risk of splenosis has been suggested. Therefore, we designed a study to analyze the impact of primary hematological disease on immediate and late outcome in a prospective series of LS patients. Methods: We performed a prospective analysis of 111 LS done between February 1993 and March 1999. The patients were classified by hematological indications into the following four groups: (a) group 1, low platelet count. This group was further subdivided into group 1A, idiopathic thrombocytopenic purpura (ITP) (n= 48) and group 1B, HIV-related ITP (n= 8); (b) group 2, anemia. This group was further subdivided into group 2A, autoimmune hemolytic anemia (n= 8), and group 2B, spherocytosis (n= 11); (c) group 3, malignancy (n= 28); and (d) group 4, others (n= 8). Immediate outcomes were recorded prospectively. Hematological status and late complications were reviewed after a mean follow-up of 24 ± 18 months. Results: There were no significant differences between the groups in terms of conversion, transfusion requirements, and morbidity, although transfusion and morbidity were slightly higher in group 3. However, hospital stay was significantly longer in groups 3 and 4 than in groups 1 and 2. Long-term follow-up showed satisfactory hematological results in ≥75% of patients (group 1A, 82%; group 1B, 88%; group 2A, 88%; group 2B, 100%; group 3, 75%; group 4, 88%). Overall, late morbidity was 8.3% and mortality was 6.2%, mainly due to deaths in group 4 (six of 22 patients). Conclusion: LS is a safe and reproducible procedure for most hematological indications, with a similar immediate outcome for benign diseases and a long-term hematological response comparable to the standard results that have been observed in open series. Springer-Verlag New York Inc., 2000 Key words: Anemia — Autoimmune thrombopenia — Hematological disease — Laparoscopic splenectomy — Splenectomy — Splenomegaly nationallicence Trias M. Service of General and Digestive Surgery, Hospital de S. Pau, Autonomous University of Barcelona, C/P Claret 167, 08025 Barcelona, Spain, ES aut Targarona E. M. Service of General and Digestive Surgery, Hospital de S. Pau, Autonomous University of Barcelona, C/P Claret 167, 08025 Barcelona, Spain, ES aut Espert J. J. Service of General and Digestive Surgery, Hospital Clinic, C/P Claret 167, 08025 Barcelona, Spain, ES aut Cerdan G. Service of General and Digestive Surgery, Hospital de S. Pau, Autonomous University of Barcelona, C/P Claret 167, 08025 Barcelona, Spain, ES aut Bombuy E. Service of General and Digestive Surgery, Hospital Clinic, C/P Claret 167, 08025 Barcelona, Spain, ES aut Vidal O. Service of General and Digestive Surgery, Hospital Clinic, C/P Claret 167, 08025 Barcelona, Spain, ES aut Artigas V. Service of General and Digestive Surgery, Hospital de S. Pau, Autonomous University of Barcelona, C/P Claret 167, 08025 Barcelona, Spain, ES aut Surgical Endoscopy Springer-Verlag 14/6(2000-06-01), 556-560 0930-2794 14:6<556 2000 14 464 https://doi.org/10.1007/s004640000149 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000149 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Trias M. Service of General and Digestive Surgery, Hospital de S. Pau, Autonomous University of Barcelona, C/P Claret 167, 08025 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Targarona E. M. Service of General and Digestive Surgery, Hospital de S. Pau, Autonomous University of Barcelona, C/P Claret 167, 08025 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Espert J. J. Service of General and Digestive Surgery, Hospital Clinic, C/P Claret 167, 08025 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Cerdan G. Service of General and Digestive Surgery, Hospital de S. Pau, Autonomous University of Barcelona, C/P Claret 167, 08025 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Bombuy E. Service of General and Digestive Surgery, Hospital Clinic, C/P Claret 167, 08025 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Vidal O. Service of General and Digestive Surgery, Hospital Clinic, C/P Claret 167, 08025 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Artigas V. Service of General and Digestive Surgery, Hospital de S. Pau, Autonomous University of Barcelona, C/P Claret 167, 08025 Barcelona, Spain, ES aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/6(2000-06-01), 556-560 0930-2794 14:6<556 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer