Laparoscopic unroofing of splenic cysts results in a high rate of recurrences

Schier, Felix; Waag, Karl-Ludwig; Ure, Benno M.

doi:10.1016/j.jpedsurg.2007.07.012

Cited by 63 publications

(55 citation statements)

References 14 publications

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“…We performed a total splenectomy in previous years for three of the ten patients that had multiple cysts, cysts covering all of the splenic parenchyma, and cysts settled in the midupper pole extending to the hilum, as described in the literature [15]. Thereafter, with conservative splenic surgery gaining popularity, we performed partial splenectomy (n=2) preserving more than 25 % of the splenic parenchyma, which is the minimal splenic tissue required to preserve immunologic protection [2] and total cyst excision (either open n=4 or laparoscopically n=1) regardless of the cysts' location, size, and proximity to the hilum based on our subsequent experiences.…”

Section: Discussionmentioning

confidence: 99%

“…Although unroofing technique is used in a small number of cases, and rarely in adults, it has been the preferred laparoscopic approach in childhood. However, our experience in laparoscopic spleen surgery is limited, and there are high recurrence rates (50-88 % was reported in children) in the literature [15,16]; we performed laparoscopic cyst excision (unroofing) in the last patient. Unfortunately, we observed a 130-mm cyst recurrence after 1 month and still following up the case at 6 months.…”

Section: Discussionmentioning

confidence: 99%

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Spleen Salvaging Treatment Approaches in Non-parasitic Splenic Cysts in Childhood

et al. 2015

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The aim of this study was to evaluate our experience with primary non-parasitic splenic cysts (NPSC) which are relatively rare in children and consist almost exclusively of single case reports or small case series in the literature. The medical records of all patients who presented to our clinic with NPSC between 2005 and 2015 were evaluated retrospectively. There were 22 children whose ages ranged from 2 months to 14 years (mean 9.2±4.7 years). The size of the cysts was in the range of 5 to 200 mm (mean 55.4±48.2 mm). Ten patients underwent surgery for splenic cysts. Partial splenectomy (n=2), total cyst excision (either open n=4 or laparoscopically n=1), and total splenectomy (n=3) were performed. The non-operated patients were asymptomatic and followed with ultrasound (US). The follow-up period in non-operated patients ranged from 6 months to 5 years (mean 2.27 ± 1.29 years). Complete regression was observed in four (33 %) non-operated patients. The regressed cyst measurements were 10, 16, 30, and 40 mm, respectively. Approximately half of the NPSC is diagnosed incidentally. Small (<5 cm) asymptomatic cysts should be under regular follow-up with US/physical examination for regression. If surgery is required, we prefer open cyst excision as it gives excellent results and preserves splenic immune function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spleen Salvaging Treatment Approaches in Non-parasitic Splenic Cysts in Childhood

et al. 2015

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“…ЛС-фенестрация также со-пряжена с риском рецидива у 22-64% больных [12,28]. Лучшие результаты сопровождают радикальное удаление НК селезенки за счет резекции органа.…”

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Robot-assisted and laparoscopic partial splenectomy for nonparasitic cysts

Берелавичус¹,

Smirnov²,

Ionkin³

et al. 2015

Khir. Z. im. N.I. Pirogova

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“…They had a median operating time of 90 min and 12 months median follow up resulting in 44% recurrence (Czauderna et al, 2006). Two other large case series with 13 and 14 patients described symptomatic recurrence rates of 7.6 and 7.1% respectively (Langer et al, 2008;Schier et al, 2007). Two other adult series consisting of 6 and 7 patients reported recurrence rates of 16 and 28%, respectively (Mertens et al, 2007;Chin et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…Based on these data and the pooled symptomatic recurrence rates in our review we suggest that recurrence rates would be around 20-25%. In cases of symptomatic recurrence repeat laparoscopic partial cyst excision is a valid alternative depending on the surgeon skill and preference as well as cyst characteristics (Schier et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Partial Cystectomy for Non-Parasitic Splenic Cyst: A Case and Literature Review

Tennakoon¹,

Jodlowski²,

Carney³

2015

J. of Medical Sciences

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Nonparasitic splenic cysts are rare and no treatment guidelines exists. Laparoscopic partial cystectomy is an attractive minimally invasive spleen preserving treatment option. The aim of this paper is to share our experience and review evidence to support laparoscopic partial cystectomy. A search was performed of PubMed and Ovid Embase. All human studies published in English language describing laparoscopic management of non-parasitic splenic cysts without any age restrictions were reviewed. Forty two studies fulfilled inclusion and exclusion criteria out of 254 studies. The total number of patients were 134. All studies were case reports or retrospective case series which ranged in size from one to 14 patients. Ten studies (24%) involved paediatric patients. Majority of patients were female. Median age ranged from 8.5-43 and median operative time varied between 56-120 min. One study reported bleeding from the cyst wall requiring splenectomy. All other studies did not report any major intra operative or post-operative complications. Median follow up period varied from 6-60 months. Overall recurrence rates varied from 0-100%. When all 134 partial cyst excisions are considered overall, 25 patients developed recurrent cysts leading to a recurrence rate of 19%. Only 13 patients (9.7%) developed symptomatic recurrences needing further intervention. Laparoscopic partial cyst excision is a relatively straightforward safe and effective spleen preserving surgical option with acceptable recurrence rate in the treatment of nonparasitic symptomatic splenic cysts.

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Laparoscopic unroofing of splenic cysts results in a high rate of recurrences

Cited by 63 publications

References 14 publications

Spleen Salvaging Treatment Approaches in Non-parasitic Splenic Cysts in Childhood

Spleen Salvaging Treatment Approaches in Non-parasitic Splenic Cysts in Childhood

Robot-assisted and laparoscopic partial splenectomy for nonparasitic cysts

Laparoscopic Partial Cystectomy for Non-Parasitic Splenic Cyst: A Case and Literature Review

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