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179138

Predictors for conversion in laparoscopic splenectomy: A prospective randomized study

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Last updated: 23 Jan 2023

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Abstract

Background & objectives: Laparoscopic splenectomy had become the golden standard for elective splenectomy, as it is feasible, safe and provides many advantages to the patients in comparison to open splenectomy, and the growing experience and the advances in equipment had made it feasible in situations that were thought to be contraindications in the past. However, some cases still require conversion to an open procedure. Identifying predictive factors for conversion   carries   crucial   benefits   for   patients   and   health   care   providers. Methods: 24 patients underwent elective laparoscopic splenectomy for different indications in our hospital between January 2008 and February 2010. Patients' data whether preoperative, operative or postoperative were collected and assessed statistically to identify the risk factors for conversion to open splenectomy. Results: The study included 24 patients (13 ITP, 5 spherocytosis, 4 chronic lymphocytic leukemia (CLL) and 2 Lymphoma patients). The rate of conversion was 16.7% (4 patients). The mean operative time was 116.5 ± 23.9 minutes; the mean estimated intraoperative blood loss was 286.5 ± 165.7 ml. The mean period until passage of flatus was 2 ± 1.1 days, patients resumed oral food intake in 3.2 ± 1.4 days and were discharged from the hospital in 4.6 ± 1.9 days. 4 patients had post operative complications in their hospital stay, and one needed reexploration. The significant risk factors for conversion in the study was diagnosis, ASA score 3, presence of technical difficulty, preoperative platelet count <71x103 cm3, splenic longitudinal axis length >17 cm and intraoperative blood loss > 500 ml. Conclusions: Proper analysis of all factors affecting successful completion of laparoscopic splenectomy will lead to better implementation of the procedure in context with patient's needs and the technical expertise of the surgical team, both leading to better outcomes. This will also help   to   address   the   areas   of   potential   improvements   to   be   implemented.

DOI

10.21608/asjs.2011.179138

Authors

First Name

Moemen

Last Name

Abo Shloaa

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Affiliation

Department of General Surgery, Ain Shams University, Cairo, Egypt.

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First Name

Gamal

Last Name

El Moaled

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Affiliation

Department of General Surgery, Ain Shams University, Cairo, Egypt.

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First Name

Mahmoud

Last Name

Saad

MiddleName

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Affiliation

Department of General Surgery, Ain Shams University, Cairo, Egypt.

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First Name

Mostafa

Last Name

foaad

MiddleName

-

Affiliation

Department of General Surgery, Ain Shams University, Cairo, Egypt.

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Orcid

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First Name

Haitham

Last Name

El Maleh

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-

Affiliation

Department of General Surgery, Ain Shams University, Cairo, Egypt.

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Volume

4

Article Issue

1

Related Issue

25653

Issue Date

2011-01-01

Receive Date

2021-06-21

Publish Date

2011-01-01

Page Start

19

Page End

28

Print ISSN

2090-7249

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https://asjs.journals.ekb.eg/article_179138.html

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https://asjs.journals.ekb.eg/service?article_code=179138

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3

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Original Article

Type Code

1,943

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Journal

Publication Title

Ain Shams Journal of Surgery

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https://asjs.journals.ekb.eg/

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Article

Created At

23 Jan 2023