Abstract:
BACKGROUND:This study was undertaken to compare safety, outcome, and costs of laparoscopic (LS) and open splenectomy (OS) for a variety of hematologic diseases. STUDY DESIGN:The records of 137 patients who underwent splenectomy (63 LS and 74 OS) at a large private teaching hospital between March 1991 and April 1996 were reviewed retrospectively. Diagnosis, age, gender, operative time, blood loss, splenic weight, time to resumption of oral diet, postoperative hospital stay, morbidity, mortality, and costs (direct and operative) were analyzed by multivariate statistical analysis. RESULTS:Laparoscopic splenectomy patients had significantly shorter hospitalization and time to resumption of an oral diet (p < 0.01); although operative costs were higher, total direct costs were not. Idiopathic thrombocytopenic purpura patients had earlier resumption of an oral diet after LS, shorter postoperative stay, and comparable OR time. Five patients (7%) were converted, with outcomes similar to OS except for greater operative time and cost. Grade II complications occurred in three LS and four OS patients; Grade III in three OS patients; and Grade IV in two OS patients. There were two major complications of LS and eight of OS, with two deaths. Multivariate analysis showed that operative time and time to resumption of oral intake were significantly related to age, diagnosis, operative technique, and splenic weight. Duration of postoperative hospitalization was related to operative technique, splenic weight, and major complications. Costs (direct and operative) were related to age, splenic weight, and major complications, but not to operative technique. CONCLUSIONS:LS results are influenced by splenic weight, disease, and age. Splenic weight appears to be the crucial determinant of operative time and length of hospitalization. LS is a superior treatment for patients with idiopathic thrombocytopenic purpura and patients with small spleens.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Friedman RL,Hiatt JR,Korman JL,Facklis K,Cymerman J,Phillips EHsubject
Has Abstractpub_date
1997-07-01 00:00:00pages
49-54issue
1eissn
1072-7515issn
1879-1190pii
S1072751597000082journal_volume
185pub_type
杂志文章abstract:BACKGROUND:Severe secondary hyperparathyroidism, which is associated with life-threatening complications, can develop in dialysis-dependent end-stage renal disease patients. The aim of this study was to compare short- and long-term mortality in dialysis patients who underwent near-total parathyroidectomy (NTPTX) and ma...
journal_title:Journal of the American College of Surgeons
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abstract:BACKGROUND:The Michigan Trauma Quality Improvement Program (MTQIP) is a collaborative quality initiative sponsored by Blue Cross Blue Shield of Michigan and Blue Care Network (BCBSM/BCN). The MTQIP benchmark reports identified our trauma center as a high outlier for venous thromboembolism (VTE) episodes. This study out...
journal_title:Journal of the American College of Surgeons
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
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journal_title:Journal of the American College of Surgeons
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更新日期:1996-11-01 00:00:00
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journal_title:Journal of the American College of Surgeons
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更新日期:2012-08-01 00:00:00
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journal_title:Journal of the American College of Surgeons
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更新日期:1998-12-01 00:00:00
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journal_title:Journal of the American College of Surgeons
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更新日期:1994-02-01 00:00:00
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journal_title:Journal of the American College of Surgeons
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更新日期:2011-03-01 00:00:00
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journal_title:Journal of the American College of Surgeons
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更新日期:2005-01-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-07-01 00:00:00
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journal_title:Journal of the American College of Surgeons
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更新日期:2018-07-01 00:00:00
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journal_title:Journal of the American College of Surgeons
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更新日期:1997-09-01 00:00:00
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更新日期:1998-11-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2014-01-01 00:00:00
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journal_title:Journal of the American College of Surgeons
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pub_type: 杂志文章
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journal_title:Journal of the American College of Surgeons
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更新日期:2017-04-01 00:00:00
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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更新日期:2003-12-01 00:00:00
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