Pediatric laparoscopic splenectomy is a relatively new surgical procedure,
Advances in instrumentation and technique now make this procedure possible.
Splenectomy is frequently performed in children for various hematologic an
d autoimmune diseases.
Patients and methods, - This article reviews the indication for splenectomy
, the technique of laparoscopic splenectomy and our results. Between Januar
y 1996 and January 2000, 23 children underwent laparoscopic splenectomy. Th
ree of them also had a concomitant cholecystectomy. Their ages ranged from
three to 14 years. Nine children had hereditary spherocytosis, four were af
fected by sickle cell disease, three had an idiopathic thrombocytopenia and
three a hemolytic disease. One patient was converted.
Results. - Mean operative time was 170 min (range, 115-230 min). Hospital s
tay ranged from three to 15 days (median, 6). Five patients had complicatio
ns (three pneumonia and two deep abcesses). Median follow-up was 20 months
(two months to four years) without problems regarding procedure. Conclusion
. - Regarding the low complication rate for this type of patient and the ad
vantages of a small abdominal trauma in the postoperative period, the lapar
oscopic approach for elective splenectomy in hematological disorders is the
technique of choice. (C) 2001 Editions scientifiques et medicales Elsevier
SAS.