Table 3.
Risk factors for difficult splenectomy.
| Parameter | Difficult Splenectomy | Control Group | OR | 95% CI | p-Value |
|---|---|---|---|---|---|
| n (%) | 56 (12%) | 412 (88%) | n/a | n/a | n/a |
| Univariate | |||||
| Age, median years (IQR) | 51 (35–62) | 46 (28–58) | 1.01 | 1.00–1.03 | 0.150 |
| Males/Females, n (%) | 29/27 (52%/48%) | 144/268 (35%/65%) | 0.50 | 0.28–0.88 | 0.016 |
| BMI, median kg/m2 (IQR) | 26.43 (23.66–28.04) | 25.83 (22.55–29.38) | 0.99 | 0.91–1.08 | 0.790 |
| ITP vs. other, n (%) | 18/38 (32%/68%) | 235/177 (57%/43%) | 2.80 | 1.54–5.08 | 0.001 |
| US length of spleen, median cm (IQR) | 19 (14–22) | 13 (11–17) | 1.14 | 1.09–1.20 | <0.001 |
| US length of spleen ≥19 cm, n (%) | 28 (54%) | 60 (15%) | 6.59 | 3.57–12.16 | <0.001 |
| Lowest preoperative platelets, median 103/mm3 (IQR) | 8 (6–23) | 8 (3–15) | 1.00 | 0.98–1.03 | 0.772 |
| Preoperative platelets, median 103/mm3 (IQR) | 55 (31–64) | 83 (50–120) | 1.00 | 0.99–1.03 | 0.268 |
| Need for extra method of preparing patients for LS, n (%) | 20 (36%) | 252 (61%) | 0.35 | 0.20–0.63 | <0.001 |
| Accessory spleen, n (%) | 4 (7.14%) | 69 (16.75%) | 0.38 | 0.12–1.10 | 0.073 |
| Technique, n (%) -vessels first -hilar transection |
19 (34%) 37 (66%) |
150 (36%) 262 (64%) |
1.15 | 0.58–2.25 | 0.694 |
| Year of surgery | 1.07 | 1.01–3.90 | 0.027 | ||
| Multivariate | |||||
| Male sex | 0.58 | 0.31–1.10 | 0.094 | ||
| Diagnosis other than ITP | 0.98 | 0.35–2.75 | 0.965 | ||
| US length of spleen ≥19 cm | 5.46 | 2.45–12.18 | <0.001 | ||
| Need for extra method of preparing patients for LS | 0.87 | 0.33–2.27 | 0.768 | ||
| Year of surgery | 1.10 | 1.10–1.19 | 0.011 | ||
IQR—interquartile range, OR—odds ratio, CI—confidence interval, BMI—body mass index, ITP—idiopathic trombocytopenia, US—ultrasound, LS—laparoscopic splenectomy.