Comparison of perioperative results of single port laparoscopic, multiple port laparoscopic and open splenectomy in patients with non-traumatic splenic diseases: clinical retrospective trial

Background and Aim; Minimally invasive surgery is preferred by surgeons in recent years due to more patient satisfaction and less perioperative complications in general surgery practice as it is in many areas. For splenectomy, the direction of surgery towards minimally invasive surgery is increased, although the surgical type differs according to the indications. Single-port procedure is a new technique, and although it is reported that perioperative complications are less with conventional laparoscopy and open procedure, the number of studies comparing the perioperative outcomes of all 3 techniques is not high. The aim of this study is to compare the perioperative outcomes of splenectomy performed by these 3 techniques in non-traumatic splenic diseases. Material and Method: Between June 2011 and December 2016 in Ege University General Surgery Department, a total of 82 patients (aged 18-72 years ) who underwent splenectomy in our hospital due to non-traumatic reasons were investigated recspectively. Patients were alienated into three groups according to the procedure type including single port splenectomy, multiple port laparoscopic splenectomy, open splenectomy. Peri-operative and post-operative recorded data of these patients; Operational indications, ASA score, intraoperative complication, duration of operation, duration of hospital stay, surgical post-operative complications and general post-operative complications were statistically analyzed for these 3 groups. Results: There were 38 patients in group 1, 34 patients in group 2 and 10 in group 3. There was no significant difference between sex, mean age and ASA scores in all 3 groups. There was no significant difference between intraoperative bleeding and post-op complications in all three groups. Patients who underwent surgery due to ITP were: in gruop 1 26.4%, Group 2: 91.2%, Group 3: 80%. (P1 and p3 > 0.05) The mean duration of operation in group 1 was 81 min ± 17, in group 2 81 min ± 22 and in group 3 te 97 min ± 22 ( p1 and p3 >0.05 p2 <0.05) The duration of hospital stay was 3.4 days (± 0.72) in group 1, 3.1 days (± 1.10) in group 2, and ± (0.7) in group 3 .(P1<0.05, p<>0.05 and p3 <0.05) In group 2, open splenectomy was performed because of intraoperative splenic venous injury in 2 patients. In Group 3, laparoscopic splenectomy was performed because of the difficulty of dissection. In Group 2 , in a patient during the marsupialization, small bowel injury occurred and the open procedure was performed. Conclusion: Single port laparoscopic splenectomy is a safe and effective alternative to both standard laparoscopic and open splenectomy. Key Words: Single port splenectomy, laparoscopic splenectomy, open splenectomy