Meta-analysis Comparing Hand-assisted Versus Conventional Laparoscopic Splenectomy

Objective: Laparoscopic splenectomy has been widely applied for the resection of spleens. We conducted a systematic review and meta-analysis to evaluate the safety and feasibility when comparing hand-assisted laparoscopic splenectomy(HALS) with conventional laparoscopic splenectomy(CLS). Methods: Pubmed, MEDLINE, Embase databases, Cochrane library, OVID, CNKI and Wan fang Date were searched for relevant studies published between 2000 and August 2012. The quality of the studies was assessed, and meta-analyses were performed with the Cochrane Collaboration’s REVMAN 5.0 software.Results: Eleven comparative studies with 624 patients were analyzed(250 patients were treated with HLAS and 374 cases with CLS). In this study, we found patients were similar in BMI, number of patients requiring blood transfusion, post-operative complications, length of hospital stay, time to full diet and rate of mortality. There was a significant difference between HALS and CLS in splenic diameter, splenic weight, malignant case, operative time, blood loss and conversion to open surgery.Conclusion: Both HALS and CLS are safe and effective procedure for the resection of spleens. HALS may be preferable to CLS for the treatment of patients with enlarged and malignant spleens. In the future, more high-quality RCTs are required to enhance these conclusions.