Kim-Koh MJ, Souza-Gallardo LM

Language: Spanish
References: 17
Page: 20-25
PDF size: 305.49 Kb.

ABSTRACT

Introduction: Nowadays, a splenectomy is a therapeutic option for hematologic diseases, especially those that do not respond to medical treatment. It is a minimally invasive surgery and has advantages such as less postoperative pain, rapid recovery, less blood loss and better cosmetic results. Laparoscopy has become the standard approach for patients undergoing a splenectomy.
Case report: We present the case of a 34-year old male patient with idiopatic thrombocytopenic purpura. He was treated with steroid and danazol with a persistent thrombocytopenia. Due to the failure of the treatment, a laparoscopic splenectomy was performed without any complication. The extracted spleen measured 25 × 16 cm weighing 1.235 g. The surgical time was of 115 min and the transoperative loss of blood was of 800 cc.
Conclusion: The laparoscopic splenectomy is a safe and viable therapeutic option. Various studies have shown low conversion rates, less morbidity and a shorter hospital stay. Laparoscopic splenectomy is an effective therapy regardless of the size of the spleen.

REFERENCES

1. Cheng J, Tao K, Yu P. Laparoscopic splenectomy is a better surgical approach for spleen-relevant disorders: a comprehensive meta-analysis based on 15-year literatures. Surg Endosc. 2016;30:4575-88.

2. Habermalz B, Sauerland S, Decker G, Delaitre B, Gigot JF, Leandros E, et al. Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc. 2008;22:821-48.

3. Delaitre B, Maignien B, Icard P. Laparoscopic splenectomy. Br J Surg. 1992;79:1334.

4. Koshenkov VP, Németh ZH, Carter MS. Laparoscopic splenectomy: outcome and efficacy for massive and supramassive spleens. Am J Surg. 2012;203(4):517-22.

5. Corcione F, Pirozzi F, Aragiusto G, Galante F, Sciuto A. Laparoscopic splenectomy: experience of a single center in a series of 300 cases. Surg Endosc. 2012;26:2870-2876.

6. Targarona EM, Balagué C, Berindoague R, Martinez C, Hernandez P, Trias M. Laparoscopic splenectomy in massive splenomegaly. Eur Surg. 2006;38(3):176-82.

7. Feldman LS. Laparoscopic Splenectomy: Standardized Approach. World J Surg. 2011;35:1487-95.

8. Fisichella PM, Wong YM, Pappas SG, Abood GJ. Laparoscopic Splenectomy: Perioperative Management, Surgical Technique, and Results. J Gastrointest Surg. 2014;18:404- 10 .

9. Moris D, Dimitriou N, Griniatsos J. Laparoscopic Splenectomy for Benign Hematologic Disorders in Adults: A Systematic Review. In vivo. 2017;31:291-302.

10. Zhou J, Wu Z, Cai Y, Wang Y, Peng B. The Feasibility and Safety of Laparoscopic Splenectomy for Massive Splenomegaly: A Comparative Study. J Surg Res. 2001;171:e55-60.

11. Wu Z, Zhou J, Pankaj P, et al. Comparative treatment and literature review for laparoscopic splenectomy alone versus preoperative splenic artery embolization splenectomy. Surg Endosc. 2012;26:2758-66.

12. Nitta T, Fujii K, Kawasaki H, Takasaka I, Kawata S, Onaka M et al. Efficacy and surgical procedures of preoperative splenic artery embolization for laparoscopic splenectomy of massive splenomegaly: A case report. Int J Surg Case Rep. 2015;16:174-6.

13. Hellman P, Arvidsson D, Rastad J. Handport-assisted laparoscopic splenectomy in massive splenomegaly. Surg Endosc. 2000;14:1177-9.

14. Bargellini T, Martellucci J, Bruscino A, Prosperi P, Valeri A. Laparoscopic Splenectomy 15 Years After. Surg Laparosc Endosc Percutan Tech. 2014;24(1):47-9.

15. Mathioulaki A, Tzardis P Laopodis V. Laparoscopic Splenectomy - (Pros and Cons). Hellenic J Surg. 2012;84(3):172-81.

16. Al-Mulhim AS. Laparoscopic splenectomy for massive splenomegaly in benign hematological diseases. Surg Endosc. 2012;26(11):3186-9.

17. Marte G, Scuderi V, Rocca A, Surfaro G, Migliaccio C, Ceriello A. Laparoscopic splenectomy: a single center experience. Unusual cases and expanded inclusion criteria for laparoscopic approach. Updates Surg. 2013;65:115-9.