Laparoscopic splenectomy for massive splenomegaly in benign hematological diseases

Laparoscopic splenectomy has become the standard of care for benign hematological disease affecting the spleen; its role in massive splenomegaly remains controversial. In this study, we evaluated the outcome of laparoscopic splenectomies in terms of spleen size in a group of 83 patients of benign hematological diseases. From July 2003 to December 2009, 83 patients underwent laparoscopic splenectomy for various benign hematological diseases. The data were recorded and analyzed in a retrospective manner. The patients were divided in to two groups according to the spleen weight; group I < 2,000 g (n = 54) and group II > 2,000 g (n = 29). Age, sex, hematological condition, operative time, estimated blood loss, conversion to open surgery, splenic weight, length of hospital stay, time to liquid diet, and morbidity were all recorded. Laparoscopic splenectomy was completed in 79 patients (95.2 %). Operative time (p = 0.01) and estimated blood loss (p = 0.001) was more in group II. The length of hospital stay (p = 0.05) and the postoperative morbidity (p = 0.001) also were significantly more in the second group. There was no mortality. Laparoscopic splenectomy is possible and safe for massive splenomegaly in hematological disease (> 2,000 g), but it needs longer operative time and hospital stay.