Effect of vessel preservation on splenic volume and function in patients with spleen preserving distal pancreatectomies

Yohanathan, Lavanya; Loveday, Benjamin; Brar, Nishaan; Greig, Paul D.; McGilvray, Ian D.; Moulton, Carol-Anne; Gallinger, Steven; Wei, Alice C.; Cleary, Sean P.

doi:10.1016/j.hpb.2020.01.012

Cited by 9 publications

(7 citation statements)

References 15 publications

(16 reference statements)

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“…Hence, robot-assisted surgery has developed to overcome these limitations with increased freedom and improved threedimensional visualization. Because a small rupture of the splenic vessels can necessitate splenectomy (15)(16)(17)(18), robotassisted surgery is reported to greatly benefit patients, especially for improving SP rates (11,19,20). Furthermore, spleen preservation is highly recommended due to its advantages for immunity and hematopoiesis for patients with nonmalignant tumors (21).…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted distal pancreatectomy improves spleen preservation rate versus laparoscopic distal pancreatectomy for benign and low-grade malignant lesions of the pancreas

Jiang¹,

Zheng²,

Zhang³

et al. 2020

Transl Cancer Res TCR

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Background: The aim of this retrospective study was to compare robot-assisted distal pancreatectomy (RDP) with laparoscopic distal pancreatectomy (LDP) for patients with benign and low-grade malignant lesions of the pancreas.Methods: This study included 166 patients who underwent RDP (n=63) or LDP (n=103) for benign or low-grade malignant lesions of the pancreas from January 2011 to October 2018 in Changhai Hospital. A retrospective analysis was performed between the two groups. The primary points were operation time, operative blood loss, hospital stay, pancreatic fistula and spleen preservation.Results: There were no significant differences in patient characteristics or indications between RDP and LDP. Notably, among all patients, RDP was associated with a significantly higher rate of spleen preservation than that for LDP (30.2% vs. 6.8%, P<0.001), while other intraoperative variables were similar between the two groups. No death cases in the study group within 30 days were reported in either group. Referring to postoperative outcomes, postoperative pancreatic fistula (POPF) was 22% for the RDP group and 33% for the LDP group. In addition, the rate of clinically significant grade B/C pancreatic fistula was 5% and 7%, respectively. There were also no significant differences in hospital stay (6.0±3.0 vs. 6.4±2.5, P=0.404).Furthermore, the univariate analysis demonstrated that tumor size (P=0.001) and surgery group (RDP/LDP) (P=0.002) were associated with SP rate independent factor for spleen preservation.Conclusions: RDP is an effective and safe technique with significant advantage in spleen preservation for patients with benign and low-grade malignant lesions in the distal pancreas.

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Section: Discussionmentioning

confidence: 99%

Robot-assisted distal pancreatectomy improves spleen preservation rate versus laparoscopic distal pancreatectomy for benign and low-grade malignant lesions of the pancreas

Jiang¹,

Zheng²,

Zhang³

et al. 2020

Transl Cancer Res TCR

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“…Therefore, in this study, we imported patient CT imaging into a Monaco system, delineated the target organ slice by slice, designed the target area for radiotherapy and estimated the volume of the target organ, thereby effectively demonstrating splenic changes. [19][20][21] In our study, we identified splenic shrinkage in 27.7% of patients. In addition to comparisons of lymphocyte levels in COVID-19 patients, changes in spleen volumes and ratios of spleen volume to patient (skin) volume may also predict changes in the immune status of patients with mild and more severe disease.…”

Section: Discussionmentioning

confidence: 53%

“…Splenic atrophy has also been reported during pathological examinations of COVID‐19 patients; 17,18 however, most changes in spleen volume cannot be measured by pathology directly. Therefore, in this study, we imported patient CT imaging into a Monaco system, delineated the target organ slice by slice, designed the target area for radiotherapy and estimated the volume of the target organ, thereby effectively demonstrating splenic changes 19‐21 …”

Section: Discussionmentioning

confidence: 99%

“…Splenic atrophy is a pathological finding that has been reported in some patients with COVID‐19 17,18 . Splenic volume changes, however, cannot adequately be measured by pathological analysis in most patients; therefore, we used a Monaco system in this study, which is generally used to show splenic changes during radiotherapy planning 19‐21 . We imported CT scans of selected patients into the Monaco treatment planning system and delineated the outline of the spleen, with a CT slice thickness of 5 mm.…”

Section: Methodsmentioning

confidence: 99%

“…17,18 Splenic volume changes, however, cannot adequately be measured by pathological analysis in most patients; therefore, we used a Monaco system in this study, which is generally used to show splenic changes during radiotherapy planning. [19][20][21] We imported CT scans of selected patients into the Monaco treatment planning system and delineated the outline of the spleen, with a CT slice thickness of 5 mm. Spleen and patient(skin) volumes were directly calculated using the volume estimation function of the software after outlines of the spleen and patient (skin) were delineated.…”

Section: Case Collectionmentioning

confidence: 99%

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Immunosuppression and cardiovascular dysfunction in patients with severe versus mild coronavirus disease 2019: a case series

Bao

Fang

et al. 2020

Clin & Trans Imm

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Objectives. As coronavirus disease 2019 (COVID-19) continues to spread globally, we aimed to describe and compare changes in the immune and cardiovascular systems of patients with mild versus severe COVID-19 at different time points during the course of disease. Methods. One hundred and one patients diagnosed with COVID-19 who underwent serial peripheral blood collection and chest computed tomography (CT) imaging were enrolled in this study and grouped by the severity of their illness. Changes in the immune and cardiovascular systems were analysed and compared between groups. Results. The study included 43 women and 58 men, with a median age of 45 years (interquartile range [IQR], 16-71). We identified spleen shrinkage in 27.7% of study patients. Ratios of spleen volume to patient (skin) volume were compared, with evidence that severe patients had more splenic shrinkage than mild patients. Lymphopenia was observed in 65.3% of patients, and 27.3% of patients had persistently low levels of lymphocytes after discharge. Tachycardia occurred mainly during the first 2 days of hospitalisation, with increases in creatine kinase-myocardial band levels in 10 (9.9%) patients and arrhythmias in 16 (15.8%) patients. Conclusions. In addition to pulmonary manifestations, our study demonstrated that other organ systems can also be affected during COVID-19 infection, with evidence of immunosuppression and cardiovascular dysfunction, which may contribute to increased mortality rates in critically ill COVID-19 patients.

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Kimura's vs Warshaw's technique for spleen preserving distal pancreatectomy: a systematic review and meta-analysis of high-quality studies

Granieri

Bonomi

Frassini

et al. 2023

HPB

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Effect of vessel preservation on splenic volume and function in patients with spleen preserving distal pancreatectomies

Cited by 9 publications

References 15 publications

Robot-assisted distal pancreatectomy improves spleen preservation rate versus laparoscopic distal pancreatectomy for benign and low-grade malignant lesions of the pancreas

Robot-assisted distal pancreatectomy improves spleen preservation rate versus laparoscopic distal pancreatectomy for benign and low-grade malignant lesions of the pancreas

Immunosuppression and cardiovascular dysfunction in patients with severe versus mild coronavirus disease 2019: a case series

Kimura's vs Warshaw's technique for spleen preserving distal pancreatectomy: a systematic review and meta-analysis of high-quality studies

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