Laparoscopic splenectomy for non-Hodgkin lymphoma.

BACKGROUND AND OBJECTIVES: The spleen is frequently involved in patients with non-Hodgkin lymphoma (NHL). The indications for splenectomy in this disease include amelioration of symptoms from splenomegaly, correction of cytopenias, and the need to establish the diagnosis. The aim of this study was to determine the feasibility of laparoscopic splenectomy for patients with splenomegaly and NHL.

METHODS: Retrospective review was made of patients who underwent laparoscopic splenectomy for suspected NHL.

RESULTS: A total of 57 laparoscopic splenectomies have been performed in the lateral position; 9 of these patients had NHL. All patients had splenomegaly with a mean craniocaudal length of 17.8 cm and mean morcellated splenic weight of 765 gm. The mean operating-room time was 185 min, with a mean blood loss of 108 cc. None were converted to open splenectomy, and there was no mortality. The mean postoperative stay was 2-4 days. At a mean follow-up of 6.7 months, there have been no major complications or sepsis.

CONCLUSIONS: Laparoscopic splenectomy is indicated in the setting of splenomegaly and suspected lymphoma. The operation is best performed in the lateral position, which is successful in patients with massive splenomegaly.