Comparison of Laparoscopic Splenectomy Outcomes for Benign and Malignant Hemopathies.

Background

Laparoscopic splenectomy for malignant hemopathies has been associated with a higher morbidity than for benign hemopathies. Recent progress in medical and surgical treatment for malignant hemopathies may have improved the outcomes of laparoscopic splenectomy. The purpose of this study is to compare the outcomes of laparoscopic splenectomy for malignant hemopathies (SHM) and benign hemopathies (SHB). Materials and

Methods

We retrospectively reviewed all patients with hematological diseases who underwent a non-post-traumatic laparoscopic splenectomy between 2008 and 2019. Patients who suffered splenectomy for a malignant and benign disease were divided into two groups and compared.

Results

Fifty patients suffered a splenectomy for hematologic disorder, 19 patients for benign hemopathy, and 31 for malignant hemopathy. SHM group was significantly older, and had more history of abdominal surgery and significantly larger spleens (P < .05). There was no significant difference in terms of operative time (150 versus 146 minutes; P < .8) and blood loss (243 versus 402 mL; P < .26). Hospital stay for SHB and SHM groups was 5.4 and 7.6 days, respectively (P = .19). There was no significant difference in terms of early (10% versus 13%; P = 1) and late complications (0% versus 13%; P = .28). One conversion to open surgery and one perioperative death in each group (P = 1) were reported. Splenectomy effectiveness was 83% and 79% in benign hemopathy and malignant hemopathy groups (P = .91), respectively.

Conclusions

Laparoscopic splenectomy for malignant hemopathy shows similar outcomes to laparoscopic splenectomy for benign hemopathy, despite older patients, larger spleens, and more important abdominal surgery history. Higher late morbidity rate after laparoscopic splenectomy for malignant hemopathy may justify a careful follow-up.