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2009 | 81 | 12 | 619-627
Article title

Laparoscopic Spleen Preserving Procedures

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EN
Abstracts
EN
Laparoscopic splenectomy evolved into one of the principal operations of the spleen. High short- and long-term morbidity associated with asplenia has prompted surgeons to implement spleen preserving procedures.The aim of the study was to evaluate laparoscopic spleen preserving procedures with regard to their feasibility and treatment results.Material and methods. Prospective evaluation of treatment results in patients submitted to laparoscopic operations of the spleen in 2nd Department of General Surgery CM UJ in Cracow.From August 1998 until May 2009 we performed 278 laparoscopic operations of the spleen. The group consisted of 164 females and 114 males, of which 256 (92.09%) patients were operated on electively and 22 (7.91%) in emergency settings. 235 patients (84.53%) were assigned to total splenectomy (most for ITP - 142 patients). In 43 patients (15.47%) the laparoscopic spleen preserving procedure was attempted. The indications included rupture of the spleen, cysts, tumors and abscess.Results. Laparoscopic spleen preserving procedure was successfully performed in 23 out of 43 patients (53.49%). There were 9 excisions of the splenic cysts, 8 hemostases from ruptured spleen, 5 resections of the tumors and one drainage of the abscess. Postoperative complications were observed in 16 (7.66%) patients after total splenectomy, including 8 (3.4%) infectious. 3 patients (6.98%) after spleen preserving procedure were re-operated due to bleeding. There were no infectious complications in this group.Conclusions. There is a limited number of indications for laparoscopic procedures preserving splenic parenchyma. Despite high failure rate attempts to perform laparoscopic spleen sparing operation are usually beneficial due to low risk of complications, particularly infections.
Publisher

Year
Volume
81
Issue
12
Pages
619-627
Physical description
Dates
published
1 - 12 - 2009
online
25 - 1 - 2010
Contributors
  • 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow
  • 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow
author
  • 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow
  • 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow
  • 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow
References
  • Pickhardt B, Moore EE, Moore FA: Operative splenic salvage in adults: a decade perspective. J Trauma 1989; 29: 1386-91.
  • Winslow ER, Brunt LM: Perioperative outcomes of laparoscopic versus open splenectomy: a meta-analysis with an emphasis on complications. Surgery 2003; 134: 647-53.
  • Budzyński A, Bobrzyński A, Biesiada Z, i wsp.: Laparoskopowa splenektomia - doświadczenia własne. Videochirurgia 1999; 4: 42-46.
  • Park A, Marcaccio M, Sternbach M: Laparoscopic vs open splenectomy. Arch Surg 1999; 134: 1263-1269.
  • Huscher CG, Mingoli A, Sgarzini G: Laparoscopic treatment of blunt splenic injuries: initial experience with 11 patients. Surg Endosc 2006; 20: 1423-26.[PubMed]
  • King H, Shumacher HB Jr.: Splenic studies. I. Susceptibility to infection after splenectomy performed in infancy. Ann Surg 1952; 136: 239-42.
  • Drew PA, Kiroff GK, Ferrante A: Alterations in immunoglobulin synthesis by peripheral blood mononuclear cells from splenectomized patients with and without splenic regrowth. J Immunol 1984; 132: 191-96.
  • Di PF, Durig M, Wadstrom J: Role of spleen in immune response to polyvalent pneumococcal vaccine. Br Med J (Clin Res Ed) 1983; 287: 1829-1832.
  • Sullivan JL, Ochs HD, Schiffman G: Immune response after splenectomy. Lancet 1978; 1: 178-81.
  • Hansen K, Singer DB: Asplenic-hyposplenic overwhelming sepsis: postsplenectomy sepsis revisited. Pediatr Dev Pathol 2001; 4: 105-21.
  • Robinette CD, Fraumeni JF Jr.: Splenectomy and subsequent mortality in veterans of the 1939-45 war. Lancet 1977; 2: 127-29.[PubMed]
  • Pimpl W, Dapunt O, Kaindl H: Incidence of septic and thromboembolic-related deaths after splenectomy in adults. Br J Surg 1989; 76: 517-21.
  • Robertson DA, Simpson FG, Losowsky MS: Blood viscosity after splenectomy. Br Med J (Clin Res Ed) 1981; 283: 573-75.
  • Singer DB: Postsplenectomy sepsis. Perspect Pediatr Pathol 1973; 1: 285-311.
  • Dickerman JD: Bacterial infection and the asplenic host: a review. J Trauma 1976; 16: 662-68.[Crossref]
  • Velmahos GC, Toutouzas KG, Radin R: Nonoperative treatment of blunt injury to solid abdominal organs: a prospective study. Arch Surg 2003; 138: 844-51.
  • Tricarico A, Tartaglia A, Taddeo F: Videolaparoscopic treatment of spleen injuries. Report of two cases. Surg Endosc 1994; 8: 910-12.
  • Koehler RH, Smith RS, Fry W: Successful laparoscopic splenorrhaphy using absorbable mesh for grade III splenic injury: report of a case. Surg Laparosc Endosc 1994; 4: 311-15.
  • Kwon AH, Inui H, Kamiyama Y: Successful laparoscopic haemostasis using an argon beam coagulator for blunt traumatic splenic injury. Eur J Surg 2001; 167: 316-18.
  • Orcalli F, Elio A, Veronese E: Conservative laparoscopy in the treatment of posttraumatic splenic laceration using microfiber hemostatic collagen: three case histories. Surg Laparosc Endosc 1998; 8: 445-48.
  • Basso N, Silecchia G, Raparelli L: Laparoscopic splenectomy for ruptured spleen: lessons learned from a case. J Laparoendosc Adv Surg Tech 2003; 13: 109-12.[Crossref]
  • Poulin EC, Thibault C, DesCoteaux JG: Partial laparoscopic splenectomy for trauma: technique and case report. Surg Laparosc Endosc 1995; 5: 306-10.
  • Van Wyck DB, Witte MH, Witte CL: Critical splenic mass for survival from experimental pneumococcemia. J Surg Res 1980; 28: 14-17.[Crossref][PubMed]
  • Budzyński A, Bobrzyński A, Krzywoń J, i wsp.: Technika "vessel first" w technicznie trudnej splenektomii laparoskopowej. Pol Przegl Chir 2002; 74: 789-96
  • Targarona EM, Espert JJ, Bombuy E: Complications of laparoscopic splenectomy. Arch Surg 2000; 135: 1137-40.
  • Budzyński A, Bobrzyński A, Krzywoń J: Laparoskopowe operacje śledziony. Przegl Lek 2001; 58: 158-61
  • Danforth DN Jr, Thorbjarnarson B: Incidental splenectomy: a review of the literature and the New York Hospital experience. Ann Surg 1976; 183: 124-29.
  • Ziemski JM, Rudowski WJ, Jaskowiak W: Evaluation of early postsplenectomy complications. Surg Gynecol Obstet 1987; 165: 507-14.
  • Carlstedt A, Tholin B: Infectious complications after splenectomy. Acta Chir Scand 1984; 150: 607-610.
  • Griffith JP, Sue-Ling HM, Martin I: Preservation of the spleen improves survival after radical surgery for gastric cancer. Gut 1995; 36: 684-90.
  • Sasako M: Risk factors for surgical treatment in the Dutch Gastric Cancer Trial. Br J Surg 1997; 84: 1567-71.
  • Varty PP, Linehan IP, Boulos PB: Does concurrent splenectomy at colorectal cancer resection influence survival? Dis Colon Rectum 1993; 36: 602-06.
  • Shoup M, Brennan MF, McWhite K: The value of splenic preservation with distal pancreatectomy. Arch Surg 2002; 137: 164-68.
Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_v10035-009-0099-5
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