Experience in The Treatment of Splenic Malignant Tumors with Laparoscopy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 MENGLing-wei , CAIHe , CAIYun-qiang , LIYong-bin ,  PENGBing

Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

PENGBing, Email: pengbing84@hotmail.com

Keywords：

Laparoscopy; Splenic malignant tumor; Splenectomy

DOI：

10.7507/1007-9424.20160114

Video：

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Objective To investigate the experience in the treatment of splnic malignant tumors with laparoscopy. Methods The clinical data of 51 patients with splnic malignant tumor who underwent splenectomy between January 2009 and July 2015 were retrospectively reviewed. Patients were divided into two groups based on the surgical method: Open splenectomy (OS group, n=18) and laparoscopic splenectomy (LS group, n=33). The preoperative, intraoperative and postoperative data of the patients were collected and analysed, the differences of each index during perioperative period (general information), intraoperative data (operative time, estimated blood loss, the size of spleen, intraoperaive transfusion) and postoprative situation (hospital stays, the first oral intake, postoperative pancreatic fistula, rehaemorrhagia, abdominal infection or pulmonary infection and the like) were compared. Results LS group compared with OS group, the operative time of LS group was significantly shorter than that of OS group [(103.64±16.92) min vs. (144.44±31.10) min, P=0.000〕, the amount of bleeding of LS group [M (Q₂₅, Q₇₅): 60 (50, 100)〕was significantly less than the OS group [M (Q₂₅, Q₇₅): 150 (115, 210)〕, P=0.000. The hospitalization time of LS group was significantly shorter than the OS group [(13.61±9.91) d vs. (9.03±3.09) d, P=0.017〕, and the LS group has a lower indication of the postoprative complications of fever and pulmonary infection (P=0.010 and P=0.003). Conciusions Laparoscopic splenectomy is feasible in the treatment of splenic malignant tumors, the employment of laparoscopy can shorten the operative time, has the advantages of less bleeding, the shorten hospital stays, lower indication of postoprative complications, and being worthy of further popularization and application.

Citation： MENGLing-wei, CAIHe, CAIYun-qiang, LIYong-bin, PENGBing. Experience in The Treatment of Splenic Malignant Tumors with Laparoscopy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(4): 429-433. doi: 10.7507/1007-9424.20160114 Copy

1.	Morgentern L, Rosenberg J, GellerG A. Tumors of the spleen. World J Surg, 1985, 9(3): 468-476.
2.	Delaitre B, Maignien B. Splenectomy by the laparoscopic approach: report of a case. Presse Med, 1991, 20(44): 2263.
3.	Kavic SM, Segan RD, Park AE. Laparoscopic splenectomy in the elderly: a morbid procedure? Surg Endosc, 2005, 19(12): 1561-1564.
4.	Wu JM, Lai IR, Yuan RH, et al. Laparoscopic splenectomy for idio pathic thrombocytopenic purpura. Am J Surg, 2004, 187(6): 720-723.
5.	Knauer EM, Ailawadi G, Yahanda A, et al. 101 laparoscopic splene ctomies for the treatment of benign and malignant hematologic disorders. Am J Surg, 2003, 186(5): 500-504.
6.	Winslow ER, Brunt LM. Perioperative outcomes of laparoscopic versus open splenectomy: a meta-analysis with an emphasis on complications. Surgery, 2003, 134(4): 647-655.
7.	Katkhouda N, Hurwitz MB, Rivera RT, et al. Laparoscopic splenec tomy: outcome and efficacy in 103 consecutive patients. Ann Surg, 1998, 228(4): 568-578.
8.	Bassi C, Dervenis C, Butturini G, et al. Postoperativepancreatic fistula: an internatiaonal study group (ISGPF) definitiaon. Sugery, 2005, 138(1): 8-13.
9.	Park A, Marcaccio M, Sternbach M, et al. Laparoscopic vs open splenectomy. Arch Surg, 1999, 134(11): 1263-1269.
10.	Sampath S, Meneghetti AT, MacFarlane JK, et al. An 18-year review of open and laparoscopic splenectomy for idiopathic thrombocyto penic purpura. Am J Surg, 2007, 193(5): 580-584.
11.	Kucuk C, Sozuer E, Ok E, et al. Laparoscopic versus open splenec tomy in the management of benign and malign hematologic diseases: a ten-year single-center experience. J Laparoendosc Adv Surg Tech A, 2005, 15(2): 135-139.
12.	Wang X, Li Y, Zhou J, et al. Hand-assisted laparoscopic splenectomy is a better choice for patients with supramassive splenomegaly due to liver cirrhosis. J Laparoendosc Adv Surg Tech A, 2012, 22(10): 962-967.
13.	Baccarani U, Donini A, Terrosu G, et al. Laparoscopic splenectomy for hematological diseases: review of current concepts and opinions. Eur J Surg, 1999, 165(10): 917-923.
14.	Makrin V, Avital S, White I, et al. Laparoscopic splenectomy for solitary splenic tumors. Surg Endosc, 2008, 22(9): 2009-2012.
15.	Tessier DJ, Pierce RA, Brunt LM, et al. Laparoscopic splenectomy for splenic masses. Surg Endosc, 2008, 22(9): 2062-2066.
16.	Walsh RM, Heniford BT, Brody F, et al. The ascendance of laparo scopic splenectomy. Am Surg, 2001, 67(1): 48-53.
17.	Heniford BT, Park A, Walsh RM, et al. Laparoscopic splenectomy in patients with normal-sized spleens versus splenomegaly: Does size matter? Am Surg, 2001, 67(9): 854-858.
18.	Koshenkov VP, Németh ZH, Carter MS. Laparoscopic splenectomy: outcome and efficacy for massive and supramassive spleens. Am J Surg, 2012, 203(4): 517-522.
19.	Choy C, Cacchione R, Moon V, et al. Experience with seven cases of massive splenomegaly. J Laparoendosc Adv Surg Tech A, 2004, 14(4): 197-200.
20.	Rosen M, Brody F, Walsh RM, et al. Hand-assisted laparoscopic splenectomy vs conventional laparoscopic splenectomy in cases of splenomegaly. Arch Surg, 2002, 137(12): 1348-1352.
21.	Wang KX, Hu SY, Zhang GY, et al. Handassisted laparoscopic splenectomy for splenomegaly: a comparative study with conven tional laparoscopic splenectomy. Chin Med J (Engl), 2007, 120(1): 41-45.
22.	Kercher KW, Matthews BD, Walsh RM, et al. Laparoscopic splenec tomy for massive splenomegaly. Am J Surg, 2002, 183(2): 192-196.
23.	Brody FJ, Chekan EG, Pappas TN, et al. Conversion factors for laparoscopic splenectomy for immune thrombocytopenic purpura. Surg Endosc, 1999, 13(8): 789-791.
24.	Targarona EM, Espert JJ, Balague C, et al. Splenomegaly should not be considered a contraindication for laparoscopic splenectomy. Ann Surg, 1998, 228(1): 35-39.
25.	Katkhouda N, Waldrep DJ, Feinstein D, et al. Unresolved issues in laparoscopic splenectomy. Am J Surg, 1996, 172(5): 585-589.
26.	Barbaros U, Dinccag A, Sumer A, et al. Prospective randomized comparison of clinical results between hand-assisted laparoscopic and open splenectomies. Surg Endosc, 2010, 24(1): 25-32.
27.	Swanson TW, Meneghetti AT, Sampath S, et al. Handassisted laparoscopic splenectomy versus open splenectomy for massive splenomegaly: 20-year experience at a Canadian center. Can J Surg, 2011, 54(3): 189-193.

1. Morgentern L, Rosenberg J, GellerG A. Tumors of the spleen. World J Surg, 1985, 9(3): 468-476.
2. Delaitre B, Maignien B. Splenectomy by the laparoscopic approach: report of a case. Presse Med, 1991, 20(44): 2263.
3. Kavic SM, Segan RD, Park AE. Laparoscopic splenectomy in the elderly: a morbid procedure? Surg Endosc, 2005, 19(12): 1561-1564.
4. Wu JM, Lai IR, Yuan RH, et al. Laparoscopic splenectomy for idio pathic thrombocytopenic purpura. Am J Surg, 2004, 187(6): 720-723.
5. Knauer EM, Ailawadi G, Yahanda A, et al. 101 laparoscopic splene ctomies for the treatment of benign and malignant hematologic disorders. Am J Surg, 2003, 186(5): 500-504.
6. Winslow ER, Brunt LM. Perioperative outcomes of laparoscopic versus open splenectomy: a meta-analysis with an emphasis on complications. Surgery, 2003, 134(4): 647-655.
7. Katkhouda N, Hurwitz MB, Rivera RT, et al. Laparoscopic splenec tomy: outcome and efficacy in 103 consecutive patients. Ann Surg, 1998, 228(4): 568-578.
8. Bassi C, Dervenis C, Butturini G, et al. Postoperativepancreatic fistula: an internatiaonal study group (ISGPF) definitiaon. Sugery, 2005, 138(1): 8-13.
9. Park A, Marcaccio M, Sternbach M, et al. Laparoscopic vs open splenectomy. Arch Surg, 1999, 134(11): 1263-1269.
10. Sampath S, Meneghetti AT, MacFarlane JK, et al. An 18-year review of open and laparoscopic splenectomy for idiopathic thrombocyto penic purpura. Am J Surg, 2007, 193(5): 580-584.
11. Kucuk C, Sozuer E, Ok E, et al. Laparoscopic versus open splenec tomy in the management of benign and malign hematologic diseases: a ten-year single-center experience. J Laparoendosc Adv Surg Tech A, 2005, 15(2): 135-139.
12. Wang X, Li Y, Zhou J, et al. Hand-assisted laparoscopic splenectomy is a better choice for patients with supramassive splenomegaly due to liver cirrhosis. J Laparoendosc Adv Surg Tech A, 2012, 22(10): 962-967.
13. Baccarani U, Donini A, Terrosu G, et al. Laparoscopic splenectomy for hematological diseases: review of current concepts and opinions. Eur J Surg, 1999, 165(10): 917-923.
14. Makrin V, Avital S, White I, et al. Laparoscopic splenectomy for solitary splenic tumors. Surg Endosc, 2008, 22(9): 2009-2012.
15. Tessier DJ, Pierce RA, Brunt LM, et al. Laparoscopic splenectomy for splenic masses. Surg Endosc, 2008, 22(9): 2062-2066.
16. Walsh RM, Heniford BT, Brody F, et al. The ascendance of laparo scopic splenectomy. Am Surg, 2001, 67(1): 48-53.
17. Heniford BT, Park A, Walsh RM, et al. Laparoscopic splenectomy in patients with normal-sized spleens versus splenomegaly: Does size matter? Am Surg, 2001, 67(9): 854-858.
18. Koshenkov VP, Németh ZH, Carter MS. Laparoscopic splenectomy: outcome and efficacy for massive and supramassive spleens. Am J Surg, 2012, 203(4): 517-522.
19. Choy C, Cacchione R, Moon V, et al. Experience with seven cases of massive splenomegaly. J Laparoendosc Adv Surg Tech A, 2004, 14(4): 197-200.
20. Rosen M, Brody F, Walsh RM, et al. Hand-assisted laparoscopic splenectomy vs conventional laparoscopic splenectomy in cases of splenomegaly. Arch Surg, 2002, 137(12): 1348-1352.
21. Wang KX, Hu SY, Zhang GY, et al. Handassisted laparoscopic splenectomy for splenomegaly: a comparative study with conven tional laparoscopic splenectomy. Chin Med J (Engl), 2007, 120(1): 41-45.
22. Kercher KW, Matthews BD, Walsh RM, et al. Laparoscopic splenec tomy for massive splenomegaly. Am J Surg, 2002, 183(2): 192-196.
23. Brody FJ, Chekan EG, Pappas TN, et al. Conversion factors for laparoscopic splenectomy for immune thrombocytopenic purpura. Surg Endosc, 1999, 13(8): 789-791.
24. Targarona EM, Espert JJ, Balague C, et al. Splenomegaly should not be considered a contraindication for laparoscopic splenectomy. Ann Surg, 1998, 228(1): 35-39.
25. Katkhouda N, Waldrep DJ, Feinstein D, et al. Unresolved issues in laparoscopic splenectomy. Am J Surg, 1996, 172(5): 585-589.
26. Barbaros U, Dinccag A, Sumer A, et al. Prospective randomized comparison of clinical results between hand-assisted laparoscopic and open splenectomies. Surg Endosc, 2010, 24(1): 25-32.
27. Swanson TW, Meneghetti AT, Sampath S, et al. Handassisted laparoscopic splenectomy versus open splenectomy for massive splenomegaly: 20-year experience at a Canadian center. Can J Surg, 2011, 54(3): 189-193.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experience in The Treatment of Splenic Malignant Tumors with Laparoscopy

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