Hasan UCMAK, Sevgi Buyukbese SARSU, Mehmet Akif BUYUKBESE, Seyyit KUS

Laparoscopic splenectomy and infection

Kısmi laparoskopik splenektomi kalıtsal sferositozda yaygın olarak uygulanmaktadır. Splenektomi yapılanlarda kapsüllü bakterilere karşı aşılama gereklidir. El-yardımlı laparoskopik splenektominin boyutu 20 cm’den daha büyük bir dalağın çıkarılmasında etkili ve uygun olduğu bilinmektedir. Laparoskopik splenektomi daha az kanamaya, cerrahi travma ve ağrıda azalmaya, hastanede kalış süresinde kısalmaya ve erken iyileşmeye neden olur. Açık cerrahi ile karşılaştırıldığında laparoskopik yaklaşım enfeksiyöz komplikasyon oranının azaltılmasında özellikle etkilidir. Splenektominin enfeksiyöz komplikasyonları olarak yara enfeksiyonu, subfrenik apse ve bazen akciğer enfeksiyonları görülmektedir

Anahtar Kelimeler:

Laparoskopi, splenektomi, enfeksiyon

Laparoscopic splenectomy and infection

Hasan Ucmak, Sevgi Buyukbese Sarsu, Mehmet Akif Buyukbese, Seyyit Kus Partial laparoscopic splenectomy is performed commonly in hereditary spherocytosis. Vaccination against capsulated bacteria is essential before undergoing splenectomy. Hand-assisted laparoscopic splenectomy is known to be effective and convenient in the removal of a spleen larger than 20 cm in size. Laparoscopic splenectomy provides less hemorrhage, reduced surgical trauma and pain, shorter duration of hospital stay, and early recovery. Laparoscopic approach was particularly effective in reducing the infectious complication rate compared with the open surgery. Infectious complications of splenectomy were observed to be wound infection, subphrenic abscess, and sometimes pulmonary infection.

Keywords:

Laparoscopy, splenectomy, infection,

PDF

___

Delaitre B, Maignien B. Splenectomy by the laparoscopic ap- proach: report of case. Presse Med 1991; 20: 2263.
Swanson TW, Meneghetti AT, Sampath S, Connors JM, Pan- ton ON. Hand-assisted laparoscopic splenectomy versus open splenectomy for massive splenomegaly: 20-year expe- rience at a Canadian centre. Can J Surg 2011;54: 189-193.
Hama T, Takifuji K, Uchiyama K, Tani M, Kawai M, Yamaue H. Laparoscopic splenectomy is a safe and effective procedure for patients with splenomegaly due to portal hypertension. Hepatobiliary Pancreat Surg 2008; 15:304-309.
Rescorla FJ, West KW, Engum SA, Grosfeld JL. Laparoscopic splenic procedures in children: experience in 231 children. Ann Surg 2007; 246:683-687.
Gelmini R, Franzoni C, Spaziani A, Patriti A, Casciola L, Savi- ano M. Laparoscopic Splenectomy: Conventional versus ro- botic approach - A Comparative study. J Laparoendosc Adv Surg Tech A 2011; 21, 393-398.
Pattenden CJ, Mann CD, Metcalfe MS, Dyer M, Lloyd DM. Laparoscopic splenectomy: a personal series of 140 consec- utive cases. Ann R Coll Surg Engl. 2010; 92:398-402.
Podevin G, Victor A, De Napoli S, Heloury Y, Leclair MD. Lap- aroscopic splenectomy: comparison between anterior and lateral approaches. J Laparoendosc Adv Surg Tech A 2011; 21:865-868.
Akahoshi T, Tomikawa M, Kawanaka H, et al. Laparoscopic splenectomy with IFN therapy in one hundred HCV-cirrhotic patients with hypersplenism and thrombocytopenia. J Gas- troenterol Hepatol 2012; 27:286-290.
Cai YQ, Zhou J, Chen XD, Wang YC, Wu Z, Peng B. Lapa- roscopic splenectomy is an effective and safe intervention for hypersplenism secondary to liver cirrhosis. Surg Endosc 2011; 25:3791-3797.
Winslow ER, Brunt LM. Perioperative outcomes of laparo- scopic versus open splenectomy: a meta-analysis with an emphasis on complications Surgery 2003; 134:647-653.