{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:08:49Z","timestamp":1776132529604,"version":"3.50.1"},"reference-count":21,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,24]],"date-time":"2022-04-24T00:00:00Z","timestamp":1650758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The aim of this paper is to assess the effectiveness and perioperative complications of splenic surgeries in children. In 41 splenectomies, an anterior abdominal laparoscopic approach was used, with 35 including a partial laparoscopic splenectomy. Of these, three needed a conversion to open. Six patients had a total splenectomy, three of which were open. Patients ranged in age from 5 to 18 years. Splenectomy was performed for a variety of causes, including hereditary spherocytosis (n = 20), splenic cysts (n = 13), sickle cell disease (n = 3), primary malignancy (n = 1), sepsis (n = 1), embolism (n = 1), anemia (n = 1), and hypersplenism (n = 1). The average length of stay was 7.6 days, and the average operation time was 169.3 min. Pleural effusion in the left hemithorax was found in 31.6% of the patients, with 5.3% requiring a thorax drain. The majority of patients had the highest platelet count two weeks after surgery. There was no evidence of wound infection, pancreatic leak, colon perforation, or postoperative sepsis. The most encountered perioperative complication was bleeding with the need of transfusion (n = 6), and one patient needed a diaphragm repair. A partial splenectomy (PS) can be a difficult procedure with a steep learning curve. For most children who require a splenic operation, this should be the primary procedure of choice.<\/jats:p>","DOI":"10.3390\/children9050605","type":"journal-article","created":{"date-parts":[[2022,4,24]],"date-time":"2022-04-24T22:22:41Z","timestamp":1650838961000},"page":"605","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Limits in Laparoscopic Partial Splenectomy in Children"],"prefix":"10.3390","volume":"9","author":[{"given":"Christian","family":"Tomuschat","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michail","family":"Aftzoglou","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Hagens","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4972-9866","authenticated-orcid":false,"given":"Michael","family":"Boettcher","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Mannheim University Medical Center (UMM), 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-8758","authenticated-orcid":false,"given":"Konrad","family":"Reinshagen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/SLA.0b013e318155abb9","article-title":"Laparoscopic Splenic Procedures in Children: Experience in 231 Children","volume":"246","author":"Rescorla","year":"2007","journal-title":"Ann. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.jpeds.2011.09.030","article-title":"Comparative Effectiveness of Different Types of Splenectomy for Children with Congenital Hemolytic Anemias","volume":"160","author":"Rice","year":"2012","journal-title":"J. Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1007\/s00247-009-1519-8","article-title":"Hereditary Spherocytosis and Partial Splenectomy in Children: Review of Surgical Technique and the Role of Imaging","volume":"40","author":"Hollingsworth","year":"2010","journal-title":"Pediatr. Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Attina\u2019, G., Triarico, S., Romano, A., Maurizi, P., Mastrangelo, S., and Ruggiero, A. (2021). Role of Partial Splenectomy in Hematologic Childhood Disorders. Pathogens, 10.","DOI":"10.3390\/pathogens10111436"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/S0022-3468(89)80722-5","article-title":"Partial Splenectomy: The Preferred Alternative for the Treatment of Splenic Cysts","volume":"24","author":"Brown","year":"1989","journal-title":"J. Pediatr. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s00464-007-9509-0","article-title":"Laparoscopic Partial Splenectomy: Indications and Results of a Multicenter Retrospective Study","volume":"22","author":"Becmeur","year":"2008","journal-title":"Surg. Endosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/01.SLA.0000048453.61168.8F","article-title":"Clinical and Hematologic Benefits of Partial Splenectomy for Congenital Hemolytic Anemias in Children","volume":"237","author":"Rice","year":"2003","journal-title":"Ann. 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Tech."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1002\/pbc.26106","article-title":"Total versus Partial Splenectomy in Pediatric Hereditary Spherocytosis: A Systematic Review and Meta-Analysis","volume":"63","author":"Guizzetti","year":"2016","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e26592","DOI":"10.1002\/pbc.26592","article-title":"A Long-Term Follow-up Study of Subtotal Splenectomy in Children with Hereditary Spherocytosis","volume":"64","author":"Rosman","year":"2017","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/00000658-199807000-00006","article-title":"Splenomegaly Should Not Be Considered a Contraindication for Laparoscopic Splenectomy","volume":"228","author":"Targarona","year":"1998","journal-title":"Ann. 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Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jpedsurg.2015.10.028","article-title":"Hematologic Outcomes after Total Splenectomy and Partial Splenectomy for Congenital Hemolytic Anemia","volume":"51","author":"Englum","year":"2016","journal-title":"J. Pediatr. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1089\/lap.2020.0769","article-title":"Laparoscopic Partial Splenectomy: A Critical Appraisal of an Emerging Technique. A Review of the First 457 Published Cases","volume":"31","author":"Romboli","year":"2021","journal-title":"J. Laparoendosc. Adv. Surg. 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