Retrospective Cohort Study
Copyright ©The Author(s) 2021.
World J Gastrointest Surg. Sep 27, 2021; 13(9): 979-987
Published online Sep 27, 2021. doi: 10.4240/wjgs.v13.i9.979
Table 1 Demographic data for 26 patients undergoing laparoscopic partial splenectomy or open partial splenectomy

Laparoscopic, n = 10
Open, n = 16
P value
Gender (male:female)2:87:90.399
Age at operation (yr)13.1 (7.7-20.3)10.7 (5.0-18.2)0.220
Weight at operation (kg)50.5 (25.0-70.0)32.6 (18.0-70.0)0.120
Height at operation (m)1.54 (1.28-1.67)1.41 (1.10-1.85)0.316
BMI at operation (kg/m2)21.30 (14.92-25.71)16.58 (12.71-24.22)0.036
Indicating primary disease0.292
Hereditary spherocytosis (%)9 (90)14 (88)
DiGeorge syndrome (%)0 (0)2 (13)
Splenic cyst (%)1 (10)0 (0)
Duration of follow-up (yr)4.1 (2.1-5.2)6.6 (4.4-11.4)< 0.001
Table 2 Spleen characteristics

Laparoscopic, n = 10
Open, n = 16
P value
Preoperative longitudinal spleen diameter (cm)15.8 (12.2-29.0)14.0 (9.9-28.9)0.523
Postoperative spleen volume (cm3)24 (16-48)31 (11-210)0.244
Total splenectomy leaving the accessory spleen (%)2 (20)0 (0)0.138
Splenic US visibility in follow-up sonography (%)4 (57) —n = 711 (79) —n = 140.354
Table 3 Operative variables

Laparoscopic, n = 10
Open, n = 16
P value
Operative time (min)185 (135-298)144 (112-270)0.048
Simultaneous cholecystectomy (%)6 (60)13 (81)0.369
Primary (first PS) operation (%)10 (100)15 (94)1
Secondary (redo PS) operation01 (6)
Conversion to open (%)1 (10)
Table 4 Postoperative outcomes

Laparoscopic, n = 10
Open, n = 16
P value
Time from OP to initiation of feeds (h)37 (4-62)28 (16-63)0.580
Time from OP to full feeds (d)3.5 (2.0-7.0)4.0 (3.0-6.0)0.313
Time from OP to mobilization (h)46 (22-92)47 (19-98)0.812
Length of postoperative hospital stay (d)5 (3-8)5 (3-8)0.602
Morbidity (Clavien-Dindo grade I-V) (%)3 (30)9 (56)0.248
Minor morbidity (Clavien-Dindo grade I-II) (%)3 (30)8 (50)0.428
Major morbidity (Clavien-Dindo grade III-V) (%)0 (0)2 (13)0.508
Comprehensive complication index0 (0-24.20)8.66 (0-39.70)0.387
Table 5 Individual profile of postoperative adverse events graded according to Clavien-Dindo and with calculated comprehensive complication index

Postoperative adverse events
Clavien-Dindo grade
CCI
Laparoscopic
Patient 17UrticariaII20.9
Patient 18PruritusII20.9
Patient 24Pleural effusionI
External genital edemaI
Blood transfusionII24.2
Open
Patient 1Lid edemaI8.7
Patient 3UrticariaII20.9
Patient 4Pleural effusionI8.7
Patient 6Pleural effusionI8.7
Patient 7Wound dehiscenceI8.7
Patient 9ExanthemaII20.9
Patient 11Urine retention. bladder catheterizationIIIa26.2
Patient 13Wound infectionII
Redo partial splenectomyIIIb39.7
Patient 20Pleural effusionI8.7
Table 6 Perioperative hematological variables

Laparoscopic, n = 10
Open, n = 16
P value
Latest hematocrit prior to operation (%)31.6 (18.7-33.4)28.1 (24.1-35.7)0.633
Latest hemoglobin prior to operation (g/L)114 (65-122)97 (78-133)0.221
Lowest hematocrit postoperative (%)28.0 (26.0-31.0)30.0 (23.0-35.0)0.131
Lowest hemoglobin postoperative (g/L)93 (79-104)99 (67-126)0.118
Estimated blood loss (mL of RBC)87 (-45-777)-37 (-114-553)0.039
Patients receiving intra- or postoperative RBC (%)2 (20)1 (6)0.538
Patients receiving intra- or postoperative FFP and TC (%)0 (0)2 (13)0.508
Table 7 Pain assessment and analgesics

Laparoscopic, n = 10
Open, n = 13
P value
Pain assessment1 (0-10 NRS)0.1522
Day 14 (2-6)4 (2-9)
Day 22 (0-4)4 (1-7)
Day 31.0 (0-2.5)2.0 (1.0-4.0)
Day 40 (0-1)1 (0-2)
Day 50 (0-3)0 (0-5)
Day 60 (0-4)0 (0-0)
Day 70 (0-0)0 (0-0)
Non-opioids — cumulative doses (mg/kg body weight)
Day 133.5 (10.0-48.4)37.7 (19.2-50.0)
Day 235.3 (10.0-60.5)31.6 (10.0-68.2)
Day 322.5 (0-37.0)30.3 (9.3-54.6)
Day 45.0 (0-36.3)18.2 (0-39.9)
Day 50 (0-36.3)0 (0-18.8)
Day 60 (0-65.3)0 (0-0)
Day 70 (0-36.3)0 (0-0)
Overall dose113.0 (20.1-308.0)134.8 (50.5-172.7)0.232
Opioids — cumulative doses (mg/kg body weight)
Day 10.44 (0-0.69)0.32 (0-0.51)
Day 20.42 (0-0.93)0.28 (0-0.55)
Day 30.25 (0-0.71)0.09 (0-0.55)
Day 40.08 (0-0.65)0 (0-0.31)
Day 50 (0-0.53)0 (0-0.08)
Day 60 (0-0.31)0 (0-0)
Day 70 (0-0.26)0 (0-0)
Overall dose1.06 (0.09-3.58)0.72 (0-1.75)0.343