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Lateral Versus Anterior Approach Laparoscopic Splenectomy

A Randomized-controlled Study

Fathi, Adel MD, PhD; Eldamshety, Osama MD, PhD; Bahy, Osama MSc; Denewer, Adel MD, PhD; Fady, Tamer MD, PhD; Shehatto, Fayez MD, PhD; Khater, Ashraf MD, PhD; Elnahas, Waleed MD, PhD; Roshdy, Sameh MD, PhD; Farouk, Omar MD, PhD; Senbel, Ahmed MD, PhD; Hamed, Emad-Eldeen MD, PhD; Setit, Ahmed MD, PhD

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: December 2016 - Volume 26 - Issue 6 - p 465–469
doi: 10.1097/SLE.0000000000000339
Original Articles
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Purpose of the Study: The study compares prospectively the hospital stay and postoperative complications of anterior (ALS) versus lateral (LLS) approach for laparoscopic splenectomy.

Materials and Methods: Between September 2011 and April 2015, 94 patients with splenomegaly were referred to the surgical unit in the Oncology Center of Mansoura University, Egypt. Only 80 patients with splenomegaly <30 cm underwent an open-label randomized allocation into 2 equal parallel groups. Indications were hematological in 52 patients (65%) and malignant splenic conditions in 28 patients (35%). Two patients younger than 18 years, 4 patients with splenomegaly >30 cm, and 8 patients with associated surgical comorbidities were excluded. Three days’ hospital stay reduction with LLS was suggested with a power of 80% and P-value of 0.05.

Results: The mean hospital stay was significantly shorter (P=0.001) after LLS. Laparoscopic splenectomy was completed in 68 patients (85%). Twelve patients (15%) required open splenectomy with no difference between groups. The operation time was significantly shorter in LLS (P=0.013). Blood loss (P=0.057) and blood transfusion (P=0.376) showed no difference between the two groups. The times until resumption of oral intake (P=0.019) and drain removal (P=0.011) were statistically shorter in LLS.

Conclusions: LLS is more safe and feasible with shorter hospital stay compared with ALS.

General Surgery Department, Oncology Centre of Mansoura University, Gharbya, Egypt

The authors declare no conflicts of interest.

Reprints: Osama Eldamshety, MD, PhD, Surgical Oncology, Oncology Centre of Mansoura University, Rashad street, 4 int 5, Gharbya, Egypt (e-mail: dr_osama_82@mans.edu.eg, dr_osama_82@yahoo.com).

Received April 17, 2016

Accepted September 29, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.