Our Summary

This research paper is a review and comparison of two types of surgery used to remove the spleen in children: laparoscopic splenectomy (LS) and open splenectomy (OS). These surgeries were evaluated based on factors like the length of the operation, amount of blood lost, length of hospital stay after surgery, and potential complications.

The review included 10 studies, with a total of 922 children. Of these, 508 had the laparoscopic surgery and 414 had the open surgery. The research found that the laparoscopic surgery resulted in less blood loss and shorter hospital stays, but took longer to perform.

There was no significant difference between the two surgeries in terms of removing additional spleens or post-surgical complications like fever, chest problems, or digestion issues.

In conclusion, the research suggests that laparoscopic surgery is a safe and effective alternative to open surgery for children needing their spleen removed. It has the added benefits of a shorter hospital stay and less blood loss. Therefore, it should be considered a good option for these patients.

FAQs

  1. What are the two types of surgery used to remove the spleen in children?
  2. How does the laparoscopic splenectomy compare to the open splenectomy in terms of blood loss, hospital stay, and operation length?
  3. Were there any significant differences between the two surgeries in terms of post-surgical complications or additional spleen removals?

Doctor’s Tip

A helpful tip a doctor might give to a patient undergoing splenectomy is to follow their post-operative care instructions carefully, including taking prescribed medications, avoiding heavy lifting or strenuous activities, and attending follow-up appointments. It’s also important to watch for signs of infection or complications, such as fever, excessive bleeding, or difficulty breathing, and to seek medical attention if any of these symptoms occur. Finally, patients should discuss any concerns or questions they have with their healthcare provider to ensure a smooth recovery process.

Suitable For

Patients who are typically recommended for splenectomy include those with conditions such as:

  • Immune thrombocytopenic purpura (ITP): a condition in which the immune system destroys platelets, leading to a low platelet count and an increased risk of bleeding
  • Hereditary spherocytosis: a genetic disorder that causes red blood cells to be shaped like spheres, leading to anemia and an enlarged spleen
  • Thalassemia: a genetic disorder that affects the production of hemoglobin, leading to anemia and an enlarged spleen
  • Sickle cell disease: a genetic disorder that causes red blood cells to become sickle-shaped, leading to anemia and an increased risk of infections
  • Hodgkin’s lymphoma: a type of cancer that affects the lymphatic system, including the spleen
  • Non-Hodgkin’s lymphoma: another type of cancer that can affect the spleen
  • Splenic abscess: an infection of the spleen that may require surgical removal
  • Trauma: severe injuries to the spleen that cannot be managed conservatively

It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if splenectomy is the best course of action for them.

Timeline

Before splenectomy, a patient may experience symptoms such as abdominal pain, fatigue, frequent infections, and an enlarged spleen. They may undergo imaging tests and blood work to determine the need for surgery.

After splenectomy, the patient may experience pain and discomfort at the surgical site, as well as fatigue and weakness. They will need to follow a strict diet and avoid certain activities to prevent complications. Over time, the patient’s immune system will adjust to the absence of the spleen, but they will need to take precautions to prevent infections, such as receiving vaccinations for certain diseases. Regular follow-up appointments with a healthcare provider will also be necessary to monitor the patient’s health and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about splenectomy include:

  1. What are the reasons for recommending a splenectomy in my case?
  2. What are the risks and benefits of both laparoscopic splenectomy and open splenectomy?
  3. How long will the surgery take and how much blood loss can be expected?
  4. What is the typical recovery time and length of hospital stay for each type of surgery?
  5. What are the potential complications and side effects of the surgery?
  6. Will I need any additional vaccinations or medications after the surgery to protect against infections?
  7. How will my immune system be affected by the removal of my spleen?
  8. What follow-up care will be needed after the surgery?
  9. Are there any long-term effects or considerations to be aware of after having a splenectomy?
  10. Are there any alternative treatments or options to consider before proceeding with a splenectomy?

Reference

Authors: Feng S, Qiu Y, Li X, Yang H, Wang C, Yang J, Liu W, Wang A, Yao X, Lai XH. Journal: Pediatr Surg Int. 2016 Mar;32(3):253-9. doi: 10.1007/s00383-015-3845-2. Epub 2015 Dec 11. PMID: 26661732