Combined subtotal gastrectomy and splenectomy after partial splenic embolization for a patient with gastric cancer and immune thrombocytopenic purpura: A case report

Kaneko, Yuki; Saito, Shin; Takahashi, Daijiro; Ui, Takashi; Higashi, Hidenori; Kurashina, Kentaro; Yamaguchi, Hironori; Hosoya, Yoshinori; Kitayama, Joji; Lefor, Alan Kawarai; Sata, Naohiro

doi:10.1016/j.ijscr.2019.08.027

Cited by 1 publication

(4 citation statements)

References 16 publications

(17 reference statements)

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“…We identified 109 citations through our comprehensive literature search, of which 49 citations were retrieved for detailed review (Figure 1). Twelve citations (22 patients) described the use of SE for the treatment of ITP but only as a bridging therapy prior to splenectomy 22–33 . These studies could not be used for the analysis of effectiveness.…”

Section: Resultsmentioning

confidence: 99%

“…It is noteworthy to highlight the utilization of SE as a bridging therapy before splenectomy to reduce the risk of perioperative bleeding, or the need of perioperative red blood cell (RBC) or platelet transfusion 22–33,65 . In addition, SE has been successfully applied to treat refractoriness to RBC transfusion secondary to hypersplenism, potentially predicting the utility of subsequent splenectomy 66–68 .…”

Section: Discussionmentioning

confidence: 99%

“…Twelve citations (22 patients) described the use of SE for the treatment of ITP but only as a bridging therapy prior to splenectomy. [22][23][24][25][26][27][28][29][30][31][32][33] These studies could not be used for the analysis of effectiveness. After exclusion of review publications and duplicate reports, 24 reports were included in the final analysis.…”

Section: R E Su Ltsmentioning

confidence: 99%

“…It is noteworthy to highlight the utilization of SE as a bridging therapy before splenectomy to reduce the risk of perioperative bleeding, or the need of perioperative red blood cell (RBC) or platelet transfusion. [22][23][24][25][26][27][28][29][30][31][32][33]65 In addition, SE has been successfully applied to treat refractoriness to RBC transfusion secondary to hypersplenism, potentially predicting the utility of subsequent splenectomy. [66][67][68] Furthermore, though not included in the analysis of effectiveness, we identified 11 citations that described the successful use of SE in young and adult patients with ITP who were considered unsuitable candidates for splenectomy, 16,17,41,42,44,[69][70][71][72] declined surgery 73 or individuals who experienced ITP relapse post-splenectomy due to accessory spleen.…”

Section: Study Year (Reference)mentioning

confidence: 99%

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The use of splenic embolization in immune thrombocytopenia: A systematic review and meta‐analysis

Egbaria,

Touma,

Cohen‐Abadi

et al. 2024

Br J Haematol

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SummaryThe effectiveness of splenic embolization (SE) in treating refractory immune thrombocytopenia (ITP) remains uncertain. A systematic literature review was undertaken to assess the effectiveness and safety of SE in treating both paediatric and adult patients with ITP. We conducted an extensive search employing predefined criteria. We extracted platelet counts at baseline and at multiple intervals following SE, along with details of the proportion of embolized spleen parenchyma and the proportion of patients exhibiting complete or partial platelet count responses. We identified nine eligible reports for the analysis of effectiveness (228 patients) and 15 reports for the safety analysis (151 patients). Pooled estimates of complete response (platelet count >100 × 109/L) and overall response (platelet count >30 × 109/L) were 50.1% (95% CI: 38–62.3) and 74.4% (95% CI: 64.9–83.9) respectively. Most studies applied an embolization of at least 60% of the spleen parenchyma. Nearly all the patients suffered from mild adverse events (AEs), 1.3% suffered from serious AEs and one patient died (0.7%). In conclusion, SE resulted in an overall response rate in 74.4% of patients with ITP. However, this finding derives from uncontrolled studies of low to moderate quality.

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Section: Resultsmentioning

confidence: 99%

“…It is noteworthy to highlight the utilization of SE as a bridging therapy before splenectomy to reduce the risk of perioperative bleeding, or the need of perioperative red blood cell (RBC) or platelet transfusion 22–33,65 . In addition, SE has been successfully applied to treat refractoriness to RBC transfusion secondary to hypersplenism, potentially predicting the utility of subsequent splenectomy 66–68 .…”

Section: Discussionmentioning

confidence: 99%

Section: R E Su Ltsmentioning

confidence: 99%

“…It is noteworthy to highlight the utilization of SE as a bridging therapy before splenectomy to reduce the risk of perioperative bleeding, or the need of perioperative red blood cell (RBC) or platelet transfusion. [22][23][24][25][26][27][28][29][30][31][32][33]65 In addition, SE has been successfully applied to treat refractoriness to RBC transfusion secondary to hypersplenism, potentially predicting the utility of subsequent splenectomy. [66][67][68] Furthermore, though not included in the analysis of effectiveness, we identified 11 citations that described the successful use of SE in young and adult patients with ITP who were considered unsuitable candidates for splenectomy, 16,17,41,42,44,[69][70][71][72] declined surgery 73 or individuals who experienced ITP relapse post-splenectomy due to accessory spleen.…”

Section: Study Year (Reference)mentioning

confidence: 99%

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