Laparoscopic versus conventional splenectomy: experience in the general surgery service of the Central Hospital of the Instituto de Previsión Social

Abstract

Introduction: Splenectomy is indicated in the management of hematologic, oncologic, and traumatic conditions. The aim of this study was to compare the outcomes of conventional and laparoscopic approaches to splenectomy in a referral center.

Methods: An observational, comparative, cross-sectional study was conducted. Patients over 16 years of age undergoing splenectomy at the General Surgery Department of the Social Security Institute between 2019 and 2021 were included. Data were obtained from the Hospital Information System.

Results: A total of 112 patients were evaluated, 65% were male, 35% were female, with a median age of 48 years. 41% were elective surgeries and 59% were emergencies. 93% underwent conventional surgery and 7% laparoscopic surgery. Laparoscopic procedures were mainly scheduled surgeries, primarily for hematologic diseases. 44% of splenectomies were performed due to trauma, all via conventional approach. The rate of postoperative complications was 23% in conventional splenectomies and 12.5% in laparoscopic splenectomies, with postoperative bleeding being the most common complication in conventional cases. 78% had no complications.

Conclusion: Conventional splenectomy remains more common than laparoscopic splenectomy, which requires specific surgeon training, is feasible as a procedure, and offers advantages in reducing complications.