Efficacy and Complications of Open vs. Laparoscopic Splenectomy: A Systematic Review
Bibliographic record
Abstract
Splenectomy is a critical surgical intervention for various hematologic disorders, trauma, and portal hypertension. While laparoscopic splenectomy has gained popularity due to its minimally invasive nature, debates persist regarding its comparative efficacy and safety versus open splenectomy, particularly in high-risk populations. This systematic review followed PRISMA guidelines, analyzing studies from PubMed, Web of Science, Scopus, and ScienceDirect. Six comparative studies (total number = 1,320 patients) were included, assessing operative outcomes, complications, and long-term efficacy. Risk of bias was evaluated using the Newcastle-Ottawa Scale. Laparoscopic splenectomy demonstrated significant advantages, including reduced intraoperative blood loss (180 mL vs. 380 mL, p < 0.001), shorter hospital stays (6 vs. 11 days, p < 0.001), and lower complication rates (24.2% vs. 56.1%, p < 0.001). Operative times were longer for laparoscopy (185 vs. 144 minutes, p = 0.048), but conversion rates were low (0–4.8%). Pediatric outcomes were comparable, though laparoscopy had higher blood loss in some cases. Portal hypertension patients benefited from reduced transfusion needs (15% vs. 38%, p = 0.02) and lower portal vein thrombosis rates (8% vs. 22%, p = 0.03). Laparoscopic splenectomy is associated with superior perioperative outcomes and fewer complications compared to open splenectomy, supporting its preference in elective settings. However, surgeon expertise and patient selection remain crucial. Further randomized trials are needed to evaluate long-term immunological effects and cost-effectiveness.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".