Current concepts of laparoscopic splenectomy in elective patients

Table 1 Characteristics of published studies on minimally invasive splenectomy included in qualitative synthesis

Ref.	Indication	Procedures	Patient No	Patient age	Operationtime	Conversion	Class
Multiport LS
Bo et al[56]	PI-LC	LS, OS	40/40	Adult	150	2	Retrospective
Ji et al[50]	Diverse	LS	105	Adult	100	2	Prospective
Zhou et al[112]	Diverse1	LS	81	Adult	163	3	Retrospective
Nobili et al[36]	GD	LS	30	Adult	150	1	Retrospective
Murawski et al[21]	Diverse	LS	159	Pediatric	149	8	Retrospective
Barbaros et al[51]	Diverse	LS	29	Adult	71	1	Retrospective
Park et al[114]	Diverse	LS	197	All	145	6	Prospective
Park et al[110]	Diverse	LS, OS	147/63	All	77	4	Prospective
Targarona et al[37]	Diverse1	LS, OS	105/81	Adult	166	82	Retrospective
Lozano-Salazar et al[109]	ITP	LS, OS	22/27	Adult	270	2	Retrospective
Katkhouda et al[20]	HD	LS	103	Adult	161	4	Prospective
Rescorla et al[111]	HD	LS, OS	50/32	Pediatric	115	0	Retrospective
Szold et al[44]	Diverse	LS	59	All	79	1	Retrospective
Brunt et al[108]	Diverse	LS, OS	26/20	All	202	1	Retrospective
Katkhouda et al[23]	Diverse	LS	33	Adult	242	1	Prospective
Single port LS
Monclova et al[85]	Diverse	SPLS, LS, RPAS	8/15/10	Adult	83	0	Retrospective
Misawa et al[94]	Diverse	SPLS	10	Adult	230	1	Prospective
Targarona et al[84]	Diverse	SPLS	8	Adult	97	2	Retrospective
Hand-assisted LS
Swanson et al[73]	Diverse1	HALS, OS	20/19	Adult	135	1	Retrospective
Barbaros et al[71]	Diverse	HALS, OS	14/13	Adult	90	0	Prospective
Targarona et al[69]	Diverse	HALS, LS	20/36	Adult	135	1	Retrospective
Robotic splenectomy
Vasilescu et al[98]	HS	RS, LS	10/22	Adult	107	1	Retrospective
Giulianotti et al[10]	Diverse	RS	24	Adult	199	2	Prospective

¹Patients with massive splenomegaly;

²Convertion rate estimated by calculating for patient No. and %; LS: Laparoscopic splenectomy; OS: Open splenectomy; PI: Portal hypertension; LC: Liver cirrhosis; GD: Gallbladder diseases; ITP: Idiopathic thrombocytopenic purpura; BHD: Benign hematologic disorders; HD: Hematologic disorders; RPAS: Reduced port access splenectomy; SPAS: Single port access splenectomy; HS: Hereditary spherocytosis; RS: Robotic splenectomy.

Table 2 Clinical indications of laparoscopic splenectomy in elective patients (data from Italian Registry of Laparoscopic Surgery of the Spleen; period: 1993-2007; n = 676) Clinical indication %

TP
Idiopathic thrombocytopenic purpura	25
Thrombotic thrombocytopenic purpura	5.47
HIV-related thrombocytopenia	0.29
Other thrombocytopenia	5.62
HM
Non-Hodgkin’s lymphoma	20.71
Hodgkin’s lymphoma	5.62
Idiopathic myelofibrosis	1.77
Chronic lymphatic leukemia	1.03
Hairy-cell leukemia	1.03
Other HM	2.66
HA
Hereditary spherocytosis	9.17
Major beta-thalassemia	4.43
Autoimmune hemolytic anemia	1.77
Other HA	5.62
OP
Splenic cyst	2.81
Splenic angioma	1.47
Splenic artery aneurysm	0.44
Unknown	5.03

IRLSS: Italian Registry of Laparoscopic Surgery of the Spleen; HM: Hematologic malignancy; TP: Thrombocytopenic purpura; HA: Hemolytic anemia; HIV: Human immunodeficiency virus; OP: Other pathologies.