Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2021; 13(9): 979-987
Published online Sep 27, 2021. doi: 10.4240/wjgs.v13.i9.979
Comparison of perioperative outcomes between laparoscopic and open partial splenectomy in children and adolescents
Mohamed Makansi, Martin Hutter, Till-Martin Theilen, Henning C Fiegel, Udo Rolle, Stefan Gfroerer
Mohamed Makansi, Martin Hutter, Till-Martin Theilen, Henning C Fiegel, Udo Rolle, Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Frankfurt am Main 60590, Germany
Stefan Gfroerer, Department of Pediatric Surgery and Pediatric Urology, Helios Clinic Berlin-Buch, Berlin 13125, Germany
Author contributions: Makansi M performed the acquisition, analysis and interpretation of data, drafted the paper and gave final approval of the version of the article to be published; Hutter M contributed substantially to the conception and design of the study, made critical revisions to important content of the manuscript and gave final approval of the version to be published; Theilen TM, Fiegel HC and Rolle U contributed substantially to analysis and interpretation of data, provided critical revisions related to important intellectual content of the manuscript and gave final approval of the manuscript version to be published; Gfroerer S designed the research study and provided substantial contribution to acquisition, analysis and interpretation of data, contributed substantially to drafting the manuscript and gave final approval of the version to be published.
Institutional review board statement: The study protocols were reviewed and approved by the Ethics Committee of the University Hospital Frankfurt (339/18).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written informed consent.
Conflict-of-interest statement: Makansi M, Hutter M and Drs. Gfroerer S, Fiegel HC, Theilen TM and Rolle U have no conflicts of interest or financial ties to disclose in relation to this manuscript.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stefan Gfroerer, MD, PhD, Director, Department of Pediatric Surgery and Pediatric Urology, Helios Clinic Berlin-Buch, Schwanebecker Chaussee 50, Berlin 13125, Germany. stefan.gfroerer@helios-gesundheit.de
Received: February 9, 2021
Peer-review started: February 9, 2021
First decision: March 30, 2021
Revised: April 10, 2021
Accepted: July 29, 2021
Article in press: July 29, 2021
Published online: September 27, 2021
ARTICLE HIGHLIGHTS
Research background

Partial splenectomy for the treatment of hypersplenism is increasingly reported. To date no data stating which approach can be regarded as superior over the other are available.

Research motivation

The purpose of this study was to compare perioperative outcomes of laparoscopic partial splenectomy (LPS) and open partial splenectomy (OPS) in children and adolescents.

Research objectives

The objective of this study was to analyze and compare LPS and OPS with perioperative outcome parameters.

Research methods

We retrospectively reviewed all patients (n = 26) that underwent LPS (n = 10) or OPS (n = 16) between January 2008 and July 2018. Clinical data including demographics, spleen characteristics, operative and hematological variables, postoperative outcomes including pain scores and analgesic requirements as well as postoperative adverse events were analyzed.

Research results

Perioperative hematological parameters, postoperative pain scores, analgesic requirements, adverse events according to the Clavien-Dindo classification and the comprehensive complication index, median time from operation to initiation of feeds, median time from operation to full feeds, median time from operation to mobilization and median length of hospital stay did not differ between LPS and OPS. Median operative time was longer in LPS compared to the OPS group. Calculated perioperative blood loss (mL of red blood cells) was higher in the LPS group compared to OPS.

Research conclusions

This is the first study that compared outcomes of LPS and OPS. LPS appears to be a viable alternative to the open operation with a broadly similar perioperative outcome providing superior cosmesis of the ventral abdominal wall.

Research perspectives

Our study results warrant a prospective multicentric clinical trial to compare outcomes in a larger group.