Vila GE, Silvera GJR, Vilorio HPL, González GJL, Pérez GD

Language: Spanish
References: 0
Page: 10-21
PDF size: 125.41 Kb.

ABSTRACT

Introduction: Laparoscopic splenectomy appeared with the development of minimal access surgery. At the moment, it has become the technique preferred for the spleen exeresis.
Objective: To evaluate the outcomes of videolaparoscopic splenectomy in the treatment of benign functional hematological diseases.
Method: A descriptive, longitudinal and prospective study was carried out with 86 patients diagnosed with benign functional hematological diseases, attended at Hermanos Ameijeiras Clinical Surgical Hospital, from October 1996 to December 2011.
Results: In the series, the female sex predominated (70.9 %) and the average age was 40 years (37.8 %). The most frequent diseases were immunological thrombocytopenic purpura (68.6 %), autoimmune hemolytic anemia (23.3 %), and hereditary spherocytosis (5.8 %). 59.3 % of patients required a preoperative preparation, with 50.9 % of effective response to it. The average surgical time was 129 minutes. The prevailing transoperative accidents were: the rupture of the extractor bag (12.8 %) and the bleeding of the splenic hilum (5.8 %). This motivated the change to conventional surgery and the exclusion of the follow-up of 6 patients. The most frequent postoperative complication was persistent vomiting. The follow-up of the patients was carried out from 7 days to 2 years in 78 % of the cases, with an average time of 518 days. There was total remission of their disease in 82.7 % of the patients, partial remission in 15.4 %, and only 1.9 % did not present any remission.
Conclusions: Videolaparoscopic splenectomy is a safe and effective technique in the treatment of autoimmune hematological diseases for surgeons with experience in advanced minimal access surgery.