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01-02-2017 | Original Scientific Report

Clinical, Anatomical, and Pathological Grading Score to Predict Technical Difficulty in Laparoscopic Splenectomy for Non-traumatic Diseases

Authors: Carlos Rodriguez-Otero Luppi, Eduardo M. Targarona Soler, Carmen Balague Ponz, Juan Pablo Pantoja Millán, Victor Turrado Rodriguez, Jose Luis Pallares Segura, Jesus Bollo Rodriguez, Manel Trias Folch

Published in: World Journal of Surgery | Issue 2/2017

Abstract

Background

We aimed to develop a grading system based on preoperative parameters that would predict surgical difficulty and morbidity in elective laparoscopic splenectomy.

Study design

We retrospectively assessed morbidity in 439 patients who underwent laparoscopic splenectomy for benign and malignant disorders between 1993 and 2013. Medical and surgical records were reviewed and analyzed. We compared preoperative data concerning demographic, clinical, pathological, anatomical, laboratory, and radiological factors with three surgical outcomes: operative time, intraoperative bleeding, and surgical conversion. Univariate and multivariate analyses were performed to identify statistically significant variables. A logistic regression model was used to identify determinant variables and to compose a predictive score. External validation of the score was performed using an independent cohort of 353 patients.

Results

Four preoperative parameters (age, male sex, type of pathology, and spleen size based on final spleen weight) were significantly related with operative time, operative bleeding, and conversion to open surgery. Using these results, we developed a classification system with three levels of difficulty: low (≤4 points), medium (4.5–5.5 points), and high (≥6 points), based on the four preoperative parameters. The correlation was highly significant (p = <0.001) according to Spearman’s correlation. The area under the ROC curve was 0.671 (95 % CI 0.596–0.745). The external validation showed significant correlations with the present model.

Conclusions

The grading score described here is simple to calculate from the physical examination, laboratory tests, and US or CT images, and we believe it could be useful to preoperatively assess the technical complexity of laparoscopic splenectomy.

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Title: Clinical, Anatomical, and Pathological Grading Score to Predict Technical Difficulty in Laparoscopic Splenectomy for Non-traumatic Diseases
Authors: Carlos Rodriguez-Otero Luppi
Eduardo M. Targarona Soler
Carmen Balague Ponz
Juan Pablo Pantoja Millán
Victor Turrado Rodriguez
Jose Luis Pallares Segura
Jesus Bollo Rodriguez
Manel Trias Folch
Publication date: 01-02-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 2/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3683-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical, Anatomical, and Pathological Grading Score to Predict Technical Difficulty in Laparoscopic Splenectomy for Non-traumatic Diseases

Abstract

Background

Study design

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Study design

Results

Conclusions

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