Abstract:

Objective

To evaluate the safety and efficacy of laparoscopic splenectomy in the treatment of hematological diseases.

Methods

Clinical data of 32 patients with hematological diseases who underwent laparoscopic splenectomy in the First Affiliated Hospital of Nanjing Medical University from June 2018 to December 2023 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them，9 patients were male and 23 female，aged （43±18） years on average. 15 cases were diagnosed with hereditary spherocytosis，9 cases of autoimmune hemolytic anemia，6 cases of primary immune thrombocytopenia and 2 cases of lymphoma.1 case was diagnosed with grade Ⅰ splenomegaly，18 cases of grade Ⅱ splenomegaly and 13 cases of grade Ⅲ splenomegaly. The maximum diameter of spleen was （17±4） cm. Perioperative clinical efficacy and complications were observed.

Results

All patients successfully completed laparoscopic splenectomy and none was converted to open surgery. The operation time was （152±39） min，and the median intraoperative blood loss was 100 （50，275） ml. All patients were successfully discharged，and the length of postoperative hospital stay was 6.0 （4.3，7.8） d. Postoperatively，4 patients developed portal vein thrombosis，2 cases of pancreatic leakage and 1 case of incisional infection. No perioperative death occurred.

Conclusions

Laparoscopic splenectomy is safe and efficacious treatment for hematological diseases，which should be carried out under the guidance of multidisciplinary cooperation.

Key words: Laparoscopes, Splenectomy, Hereditary spherocytosis, Immune thrombocytopenia, Autoimmune hemolytic anemia, Lymphoma, Multidisciplinary team