Clinical Comparison Of Laparoscopic Splenectomy And Open Splenectomy In Treating Patients With Traumatic Splenic Rupture

Objective:Currently laparoscopic splenectomy is widely used in many conditions. Ithas become a gold standard procedure in treating some hematological systemdiseases. Splenectomy for traumatic splenic rupture is always finished throughopen surgery. As the surgen’s experience accumulates and the relating surgicalmaterials and equipment improve, it is possible to run laparoscopic splenectomyto treat patients with traumatic splenic rupture. There are only a few clinicalreports in literature about laparoscopic splenectomy for traumatic splenicrupture. Our research compares the clinical materials of patients who underwentlaparoscopic splenectomy or open splenectomy. We want to provide importantinformation to the surgeon when they treat patients with traumatic splenicrupture.Methods:In this study, we analyse patients who underwent splenectomy in ourhospital. The surgery took place from Aug.2013to Mar.2015. All of them hadtraumatic splenic rupture.12patients underwent lapatoscopic slpenectomy (LS)and15patients underwent open splenectomy (OS). We analyse the followingdata including general clinical materials, blood loss during surgery, operating time,the time when the patient can eat food after surgery,the frequency ofanalgesic drug used after surgery, length of hospital stay after surgery, total coststaying in the hospital, postoperative complications. We use two-independentsamples t-test to deal with measurement data. We use Fisher’s exact test to dealwith enumeration data. The data has statistical difference when P<0.05.Results:LS group and OS group have no difference in general clinical materialsincluding age, gender and the time interval from being injured to being admittedto hospital (P>0.05). LS group and OS group have no difference in blood lossduring surgery,the time when the patient can eat food after surgery,the frequencyof analgesic drug used after surgery, length of hospital stay after surgery, totalcost staying in the hospital(P>0.05).The operating time of LS group is longerthan that of OS group (P<0.05). LS group has lower incidence of postoperativecomplications than OS group (P<0.05).Conclusion:Laparoscopic splenectomy is safe and feasible to treat traumatic splenicrupture. Compared with open splenectomy, laparoscopic splenectomy has thefollowing benefits when splenectomy is required. Firstly when we chooselaparoscopic option, we can make sure how severe the splenic injury is. If theinjury is mild and the blood loss is rare,we can do splenorrhaphy to avoid greatpain after open surgery. Secondly the horizon is magnified during laparoscopy,so we can easily discover the bleeding point and stop bleeding exactly. Thirdly the laparoscopic technique affords the opportunity to examine other organs inthe inferior quadrants, which are not visible through the open procedure.Fourthly laparoscopic surgery has few postoperative complications and mildsurgical trauma.