Khirallah Mohammad Gharieb, Kabbash Ibrahim Ali, El-Dessouki Nagi Ebrahim
Department of Pediatric Surgery, Tanta University, Egypt.
Professor of Public Health and Community Medicine, Tanta University, Egypt.
Ann Med Surg (Lond). 2021 Jun 8;67:102463. doi: 10.1016/j.amsu.2021.102463. eCollection 2021 Jul.
laparoscopic splenectomy (LS) gained popularity during the last years among pediatric surgeons. Benign hematological diseases represent the main indications of that procedure. There are some score systems of difficulty of the technique. Most of them are for adult patients. The aim is to develop a prognostic score system of LS in children with benign hematological diseases.
LS was performed in all children with benign hematological diseases. The children were operated in lateral decubitus position. The control of pedicle was achieved using bipolar sealing devices, polymer clips or endoscopic linear stablers. Preoperative, operative, and postoperative data were recorded and analyzed. Children were divided into two groups A and B according to the onset of complications.
137 successive children were operated. The mean age of patients was 8.7 (4-15) years. The main indications of LS were thalassemia, spherocytosis, idiopathic thrombocytopenic purpura (ITP), and sickle cell anemia (SCA). The mean length of splenic axis in thalassemia and spherocytosis cases was15.6 ± 2.3 cm. The mean amount of estimated blood loss (EABL) was 149 ± 43.2 ml in group A while it was 185 ± 44.4 ml in group B. The mean operative time in group A was 75.5 ± 22.5 min while it was 89.2 ± 20.6 min in group B.
the development of prognostic score of LS in children with benign hematological diseases can predict children who are more susceptible for complications. It helps to minimize these complications and improve the outcome of LS.
近年来，腹腔镜脾切除术（LS）在小儿外科医生中越来越受欢迎。良性血液系统疾病是该手术的主要适应证。有一些技术难度评分系统。其中大多数是针对成年患者的。目的是建立一个针对患有良性血液系统疾病儿童的LS预后评分系统。
对所有患有良性血液系统疾病的儿童进行LS手术。患儿采用侧卧位进行手术。使用双极密封装置、聚合物夹或内镜直线切割缝合器控制脾蒂。记录并分析术前、术中及术后数据。根据并发症的发生情况将患儿分为A、B两组。
连续对137例患儿进行了手术。患儿的平均年龄为8.7（4 - 15）岁。LS的主要适应证为地中海贫血、球形红细胞增多症、特发性血小板减少性紫癜（ITP）和镰状细胞贫血（SCA）。地中海贫血和球形红细胞增多症病例的脾轴平均长度为15.6 ± 2.3 cm。A组的平均估计失血量（EABL）为149 ± 43.2 ml，而B组为185 ± 44.4 ml。A组的平均手术时间为75.5 ± 22.5分钟，而B组为89.2 ± 20.6分钟。
建立患有良性血液系统疾病儿童的LS预后评分可以预测更容易发生并发症的儿童。这有助于将这些并发症降至最低并改善LS的手术效果。
