Surgical strategy and controversy about upper limit of splenic size for laparoscopic splenectomy

VernacularTitle:腹腔镜脾切除术脾脏大小极限的争议与手术策略
Author: Hongchi JIANG ; Dan LI
Keywords: Splenomegaly; Laparoscopic splenectomy; Controversy
From: Chinese Journal of Digestive Surgery 2017;16(8):777-781
CountryChina
Language:Chinese
Abstract: Laparoscopic splenectomy (LS) is considered as the standard approach for patients with normal-sized or moderately enlarged spleens because of advantages of minimal invasion.With the improvement of laparoscopic techniques,the previous concept that massive splenomegaly (MS) is a contraindication to LS is being challenged.Nevertheless,there is still a tremendous controversy over this issue.(1) Splenomegaly and MS are not clearly defined.(2) The feasibility,safety and postoperative outcomes of LS for MS are fiercely debated despite much improvement of LS for MS.(3) Whether supporting or opposing LS for MS,the core problem that the upper limit of splenic size can be in accord with a requirement of LS is controversial.Taking these issues into account,authors recommended that the splenomegaly shotdd be divided into four degrees rather than three degrees for the sake of guiding the choice of surgery.