Laparoscopic near-total splenectomy. Report of a case
| Autor: | Giuseppe Di Buono, Antonino Agrusa, Leonardo Gulotta, Salvatore Buscemi, Elisa Maienza, Giorgio Romano |
|---|---|
| Přispěvatelé: | Di Buono G., Maienza E., Buscemi S., Gulotta L., Romano G., Agrusa A. |
| Rok vydání: | 2020 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty medicine.medical_treatment Splenectomy Case Report Spleen Lesion 03 medical and health sciences 0302 clinical medicine Laparoscopic splenectomy medicine Total splenectomy business.industry Splenic abscess medicine.disease Surgery medicine.anatomical_structure Near-total splenectomy 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Spleen preserving medicine.symptom Splenic disease business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • We describe a case report of near total splenectomy managed by laparoscopy for a large lesion of the upper pole of the spleen. • When total splenectomy is performed, an increased risk of potentially lethal infections arises. Asplenia and impaired splenic function are related to the increase of morbidity and mortality from infectious complications. • The overwhelming post splenectomy infections (OPSI) are mostly represented by fulminating sepsis, meningitis or pneumonia. • laparoscopic near total splenectomy is an innovative partial splenectomy technique consisting on preserving a residual spleen volume. • The comparison between other spleen preserving techniques shows that LNTS is associated with a lower rate of secondary surgery and postoperative recurrence of anaemia. Introduction Splenectomy is a surgical procedure indicated for the treatment of most benign and malignant splenic diseases, especially hematologic disorders. Laparoscopic approach is preferable to the open surgery for most indications because it reduces intra- and post-operative complications and shortens hospital stay. Laparoscopic approach is also feasible for partial splenectomy. Spleen-preserving techniques reduce the risk of severe infections and thromboembolic events that can occur after total splenectomy Case presentation We report a case of a 50-year old woman with an incidentally discovered voluminous lesion in the superior pole of spleen. A laparoscopic near-total splenectomy was performed. Discussion The evidence about the potential complications in splenectomised patients speaks in favour of performing spleen-sparing surgical techniques whenever possible. Most common indications for laparoscopic partial splenectomy are non-parasitic splenic cystic, benign splenic tumors, splenic haematological diseases, non-cystic intraparenchymal lesions, spleen rupture, splenic abscess, vascular abnormalities. Laparoscopic near total splenectomy is an innovative partial splenectomy technique consisting on preserving a residual spleen volume. Conclusion LNTS seems to be a safe and effective technique for the management of benign spleen diseases. The comparison between other spleen preserving techniques shows that LNTS is associated with a lower rate of secondary surgery and postoperative recurrence of anaemia. |
| Databáze: | OpenAIRE |
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