{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:41:41Z","timestamp":1789760501422,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To review the evidence regarding the outcomes of laparoscopic techniques in cases of splenomegaly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endoscopic approaches such as laparoscopic, hand\u2010assisted laparoscopic, and robotic surgery are commonly used for splenectomy, but the advantages in cases of splenomegaly are controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review methods<\/jats:title>\n                    <jats:p>We conducted a systematic review using PRISMA guidelines. PubMed\/MEDLINE, ScienceDirect, Scopus, Cochrane Library, and Web of Science were searched up to February 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nineteen studies were included for meta\u2010analysis. In relation to laparoscopic splenectomy (LS) versus open splenectomy (OS), 12 studies revealed a significant reduction in length of hospital stay (LOS) of 3.3\u00a0days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009&lt;0.01) in the LS subgroup. Operative time was higher by 44.4\u00a0min (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) in the LS group. Blood loss was higher in OS 146.2 cc (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009&lt;0.01). No differences were found regarding morbimortality. The global conversion rate was 19.56%. Five studies compared LS and hand\u2010assisted laparosocpic splenectomy (HALS), but no differences were observed in LOS, blood loss, or complications. HALS had a significantly reduced conversion rate (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). In two studies that compared HALS and OS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200966), HALS showed a decrease in LOS of 4.5\u00a0days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and increase of 44\u00a0min in operative time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), while OS had a significantly higher blood loss of 448 cc (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). No differences were found in the complication rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LS is a safe approach for splenomegaly, with clear clinical benefits. HALS has a lower conversion rate. Higher\u2010quality confirmatory trials with standardized splenomegaly grading are needed before definitive recommendations can be provided.<\/jats:p>\n                    <jats:p>Prospero registration number: CRD42019125251.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-020-05839-x","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T14:02:26Z","timestamp":1605103346000},"page":"465-479","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Outcomes of Laparoscopic Splenectomy for Treatment of Splenomegaly: A Systematic Review and Meta\u2010analysis"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-0176","authenticated-orcid":false,"given":"Mar\u00eda Rita","family":"Rodr\u00edguez\u2010Luna","sequence":"first","affiliation":[{"name":"IRCAD, Research Institute against Digestive Cancer France 1 Place de l'H\u00f4pital 67000 Strasbourg France"},{"name":"Gastrointestinal and Hematological Surgical Unit, Service of General and Digestive Surgery, Hospital de la Santa Creu I Sant Pau Autonomous University of Barcelona (UAB) Medical School Carrer Sant Antoni Ma Claret, 167 08025 Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Balagu\u00e9","sequence":"additional","affiliation":[{"name":"Gastrointestinal and Hematological Surgical Unit, Service of General and Digestive Surgery, Hospital de la Santa Creu I Sant Pau Autonomous University of Barcelona (UAB) Medical School Carrer Sant Antoni Ma Claret, 167 08025 Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Fern\u00e1ndez\u2010Anan\u00edn","sequence":"additional","affiliation":[{"name":"Gastrointestinal and Hematological Surgical Unit, Service of General and Digestive Surgery, Hospital de la Santa Creu I Sant Pau Autonomous University of Barcelona (UAB) Medical School Carrer Sant Antoni Ma Claret, 167 08025 Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon","family":"Vilallonga","sequence":"additional","affiliation":[{"name":"Endocrine, Metabolic and Bariatric Unit, Center of Excellence for the EAC\u2010BC, Vall d'Hebron University Hospital Universitat Aut\u00f2noma de Barcelona Passeig de la Vall d'Hebron 119\u2010129 08035 Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Mar\u00eda","family":"Targarona Soler","sequence":"additional","affiliation":[{"name":"Gastrointestinal and Hematological Surgical Unit, Service of General and Digestive Surgery, Hospital de la Santa Creu I Sant Pau Autonomous University of Barcelona (UAB) Medical School Carrer Sant Antoni Ma Claret, 167 08025 Barcelona 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October 2020","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2020","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Drs Rodriguez-Luna R, Balagu\u00e9 C, Fern\u00e1ndez-Anan\u00edn S, Vilallonga R, and Targarona Soler E. have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}