Laparoscopic Partial Splenectomy for Unknown Primary Cancer: A Stepwise Approach

Vega, Eduardo A.; Yamashita, Satoshi; Shin, Chun Yun; Kim, Michael; Fleming, Jason B.; Katz, Mathew; Raghav, Kanwal; Vauthey, Jean Nicolas; Lee, Jeffrey E.; Conrad, Claudius

doi:10.1245/s10434-016-5664-7

Cited by 6 publications

(7 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Forty‐nine publications were selected for review of full text and three duplicate publications, one article undergone LPS for pigs not human, and eight articles that we could not get detailed data were excluded from our review. Forty‐four [5, 6, 11–52] with a total of 252 patients undergoing LPS or LSS met the criteria for analysis. These included four case‐matched comparative studies.…”

Section: Resultsmentioning

confidence: 99%

“…Indications for LPS varied in these series (Table 1). The most common indications in these series were splenic cystic lesions( n = 84) [5, 6, 12–30, 51, 52], followed by splenic hematological diseases ( n = 70) [5, 6, 21, 24, 31, 33–35], non‐cystic intraparenchymal lesions ( n = 59) [5, 6, 20–24, 36–44, 50, 52], spleen rupture ( n = 22) [11, 45], splenomegaly of unknown origin ( n = 9) [5], splenic abscess ( n = 3) [23, 42, 49], severe splenic pain due to ischemia provoked by vascular obstruction of the spleen ( n = 2) [47], and each for Gandy–Gamna bodies, Benign metaplasia, and undiagnosed splenic lesion [22, 48]. The most common surgical procedures performed in these series were four‐trocar laparoscopic splenectomy ( n = 117) [14, 16–18, 20, 22–24, 28, 30, 31, 35, 38, 39, 42, 43, 45, 47, 48, 50, 51], followed by three‐trocar laparoscopic splenectomy ( n = 53) [5, 15,…”

Section: Resultsmentioning

confidence: 99%

“…Various operative parameters are summarized in Table 2. The range of operative times of LPS (including combination operation) procedure was 50–225 min ( n = 37 studies) [5, 6, 11–14, 16–18, 20–26, 28, 29, 31–36, 38–46, 48–52]. The range of estimated blood loss (EBL) was 0–1200 ml ( n = 39 studies) [6, 11–18, 20–26, 28–36, 38–46, 48–52].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review

Liu

Fan

2019

World j. surg.

View full text Add to dashboard Cite

Background Laparoscopic partial splenectomy (LPS) is a challenging procedure. The aim of this review was to evaluate its feasibility, safety, and potential benefits. Methods We conducted a comprehensive review for the years 1995-2018 to retrieve all relevant articles. Results A total of 44 studies with 252 patients undergoing LPS were reviewed. Six studies described combined operations. Ranges of operative time and estimated blood loss were 50-225 min and 0-1200 ml, respectively. There are eight patients need blood transfusion in 231 patients with available data. The conversion rate was 3.6% (9/252). Overall, 27 patients (10.7%;27/252) developed postoperative or intraoperative complications. Overall mortality was 0% (0/252). The length of postoperative stay (POS) varied (1-11 days). Among four comparative studies, one showed LPS could reduce POS than laparoscopic total splenectomy (LTS) (LTS 5.4 ± 1.8 days, LPS 4.2 ± 0.8 days, p = 0.027) and complications (pleural effusion (LTS 9/22, LPS 0/15, p = 0.005), splenic vein thrombosis (LTS 10/22, LPS 0/15, p = 0.002)). Another comparative study showed LPS may benefit emergency patients. However, one comparative study showed LPS was associated with more pain, longer time to oral intake, and longer POS in children with hereditary spherocytosis. The fourth comparative study showed robotic subtotal splenectomy was comparable to laparoscopy in terms of POS and complication. The main benefits were lower blood loss, vascular dissection time, and a better evaluation of splenic remnant volume. Conclusions In early series of highly selected patients, LPS appears to be feasible and safe when performed by experienced laparoscopic surgeons.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review

Liu

Fan

2019

World j. surg.

View full text Add to dashboard Cite

show abstract

“…In this study, we analyzed 39 previously published cases (22 males, 17 females; age range, 33 to 84 years; mean, 64 years) of isolated splenic metastasis derived from CRC (Table 1). [5,8,10,14,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][34][35][36][37][38][39][40][41][42][43][44][45][46] Among them, 35 cases were metachronous metastasis and only 4 cases were synchronous metastasis. Interestingly, in terms of splenic lesions, there were only 4 cases of multiple metachronous splenic metastases, and most cases [34] were solitary.…”

Section: Discussionmentioning

confidence: 99%

Case report of isolated synchronous multiple splenic metastases from rectal cancer: A case report and brief review of the literature

Zhao

Sui

et al. 2022

Medicine

View full text Add to dashboard Cite

Introduction: Isolated splenic metastasis emanating from colorectal cancer is an extremely rare finding, which usually indicates widely disseminated and multiple metastatic cancer. There have only been 39 cases of isolated splenic metastasis reported in the English literature to date. Patient concerns: An 84-year-old female patient presented to our department with dark-red bloody stool that had persisted for 1 month and with an increased serum carcinoembryonic antigen (CEA) level. Diagnoses: A colonoscopy showed a rectal mass located 3 cm from the anal margin, which was 45 mm in diameter. The patient was diagnosed with rectal cancer with splenic metastases by abdomen computed tomography. Interventions: The patient underwent a radical resection of rectal cancer and splenectomy, and the postoperative histopathology confirmed that the splenic lesions were derived from the adenocarcinoma of the rectum. Outcomes: After surgical treatment, the patient recovered well and was recommended for further chemotherapy. Conclusions: In addition to revealing a rare case, we also performed a literature review, including a brief discussion about the atypical isolated splenic metastasis from colorectal cancer. Our findings enrich the database of this rare clinical entity and provide experience in the management of splenic metastasis.

show abstract

“…Lopez Monclova et al[ 4 ] reported 6 cases of laparoscopic metastasis splenectomy, all of which had no postoperative complication sand the total survival time ranged from 2 mo to 11 years[ 4 , 5 ]. In terms of abdominal organ malignancy, laparoscopic surgery does not result in higher surgical complications than traditional laparotomy[ 6 ]. Therefore, laparoscopic total splenectomy is safe, reproducible and results in a faster postoperative recovery than traditional surgery.…”

Section: Treatmentmentioning

confidence: 99%

Isolated metachronous splenic multiple metastases after colon cancer surgery: A case report and literature review

Hu¹,

Zhu²,

Lei³

et al. 2020

WJCC

View full text Add to dashboard Cite

BACKGROUND Isolated splenic metastasis is a rare clinical entity. Multiple metastases in the spleen after radical colon resection in a patient who subsequently underwent a second local resection for isolated metachronous splenic metastasis are exceedingly rare. CASE SUMMARY We report a colon cancer patient who underwent laparoscopic radical colon resection 14 mo previously, and subsequently underwent a second local resection due to local recurrence detected by elevated serum carcinoembryonic antigen (CEA) and positron emission tomography (PET). However, multiple metastases in the spleen were found 7 mo later by elevated serum CEA and PET-magnetic resonance imaging. Then the patient underwent total laparoscopic splenectomy. Local tumor recurrence and splenic metastasis from colorectal cancer (CRC) were found by postoperative pathology. Genetic analysis of these recurrent and metastatic tissues showed KRAS exon2, APC exon16 and TP53 exon6 missense mutations, but no mutations of NRAS, KRAF, EGFR, ERBB2, MET, MLH1, MSH2 and MSH6 were detected. Chemotherapy and target therapy were administered after multiple disciplinary team (MDT) consultation, and no tumor recurrence has been observed to date. We also reviewed the literature by conducting a search of the PubMed database using the following key words: CRC, splenic metastasis, isolated, and review. We identified 34 relevant papers, which included 28 cases of metachronous metastasis and 6 cases of simultaneous metastasis. CONCLUSION Close monitoring of serum CEA levels is crucial for the detection of isolated splenic metastases after colon surgery. In terms of overall survival and progression-free survival, MDT plays an important role in the entire process of disease management.

show abstract

Laparoscopic Partial Splenectomy for Unknown Primary Cancer: A Stepwise Approach

Cited by 6 publications

References 5 publications

Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review

Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review

Case report of isolated synchronous multiple splenic metastases from rectal cancer: A case report and brief review of the literature

Isolated metachronous splenic multiple metastases after colon cancer surgery: A case report and literature review

Contact Info

Product

Resources

About