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    Laparoscopic Splenectomy for Trauma

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    Author
    Shamim, A.A.
    Zafar, S.N.
    Nizam, W.
    Date
    2018
    Journal
    JSLS : Journal of the Society of Laparoendoscopic Surgeons
    Publisher
    Society of Laparoendoscopic Surgeons
    Type
    Article
    
    Metadata
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    See at
    https://dx.doi.org/10.4293/JSLS.2018.00050
    Abstract
    Background and Objectives: The use of laparoscopy in the trauma setting is gaining momentum, with more therapeutic procedures being performed. We evaluated the use of laparoscopic splenectomy among trauma patients with data from the National Trauma Database. We compared outcomes for trauma patients undergoing laparoscopic (LS) versus open splenectomy (OS). Methods: From the National Trauma Database (2007 to 2015), we identified all patients who underwent a total splenectomy. Patients who had other abdominal operations were excluded. All patients were categorized into 1 of 2 groups: LS or OS. Outcomes of in-hospital mortality, postoperative length of stay, and incidence of major complications between the 2 groups were compared. Bivariate parametric and nonparametric analyses were performed. Patients were then matched on baseline demographic and injury characteristics by using propensity score matching techniques, and we compared differences by using regression analysis. Results: A total of 25,408 patients underwent OS and 113 patients underwent LS (0.44%). Patients were significantly different at baseline, with the LS group being less severely injured. Bivariate analysis revealed no difference in length of stay (9 vs 8 days, P = .62), incidence of major complications (10% vs 15%, P = .24), or mortality (6% vs 11%, P = .23). LS was performed in 29.2% of patients beyond 24 hours from presentation compared with 9.5% in the OS (P < .001). Adjusted multivariate analysis showed no overall difference in outcomes. Conclusion: LS for trauma is increasingly being used at many centers throughout the United States. The procedure is safe, with outcomes similar to those of OS in selected trauma patients.
    Keyword
    Laparoscopic splenectomy
    Laparoscopic surgery
    Open splenectomy
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85059501125&doi=10.4293%2fJSLS.2018.00050&partnerID=40&md5=f7c05d00b8fe78a62f02530720da665f; http://hdl.handle.net/10713/9213
    ae974a485f413a2113503eed53cd6c53
    10.4293/JSLS.2018.00050
    Scopus Count
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    UMB Open Access Articles 2018

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