38212

Laparoscopic splenectomy versus open splenectomy in the treatment of some hematological disorders

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

General Surgery

Advisors

Barsoum, Maged S., Gubran, Hadi, Shahin, Salah A.

Authors

Aziz, Wael Naeim

Accessioned

2017-04-26 12:05:36

Available

2017-04-26 12:05:36

type

M.D. Thesis

Abstract

The purpose of this study is to evaluate the visibility of laparoscopic splenectomy in the treatment of some hematological disorders. We operated on 30 patients with hematological diseases in whom splenectomy were indicated, 15 patients (study group) underwent laparoscopic splenectomy, the other 15 patients (control group) underwent open splenectomyThe following patients were excluded from this study:1.Patients with a history of bleeding tendency apart from those caused directly by platelet disorders.2.Patients with previous upper laparotomies. 3.Diagnosis of heart, kidney, liver diseases that contraindicates laparoscopic or open surgical maneuvers.4.Huge splenomegaly5.Pregnancy.Pre operative preparations of these patients were taken in the hematology department and routine laboratory investigations were done in the form of C.B.C., liver and kidney functions& bone marrow morphology.Abdominal ultrasound imaging to assess splenic major long access & other intra abdominal pathology was done to all cases preoperatively We used the harmonic scalpel, which is dissecting and haemostatic vessel sealing tool, to the laparoscopic procedures as it operates on the base of ultrasound wave vibrations that are transmitted from it to the tissue causing cutting and haemostasis simultaneously. The use of harmonic scalpel &legasure in laparoscopic splenectomy were safe and effective as they improved haemostasis (p<0.001), ease of dissection, lessens the operative time, briefs hospitalization with rapid return to work and hence better long term results.Although the clinical implications of laparoscopic splenectomy in the treatment of some hematological disorders are not frequently observed in practice, this study suggests that laparoscopic splenectomy is ideal in the treatment of some hematological disorders as compared to open surgery as regard less operative time, brief hospitalization and hence better long term outcome in expert well trained hands in well equipped centers.

Issued

1 Jan 2008

DOI

http://dx.doi.org/10.21473/iknito-space/32156

Details

Type

Thesis

Created At

05 Feb 2023