Laparoscopic versus robotic subtotal splenectomy in hereditary spherocytosis. Potential advantages and limits of an expensive approach

Vasilescu, C; Stanciulea, Oana; Tudor, Ştefan

doi:10.1007/s00464-012-2249-9

Cited by 41 publications

(37 citation statements)

References 29 publications

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“…Those patients underwent splenic scintigraphy at one year after surgery, and then every 5 years. Vasilescu et al (7) showed a percentage less than 2 % for pitted erythrocyte in all patients, and transiently Howell-Jolly bodies in 6 of 10 patients, after surgery.…”

Section: Therapy Outcomesmentioning

confidence: 86%

“…(1) The aplastic crisis might lead to dramatic decrease of the hemoglobin concentration and, in this case, a blood transfusion is mandatory. (7) Another complication that might appear in the mild form of the disease (in patients without splenectomy) is the extramedullary hematopoiesis, with the clinical picture of intrathoracic, paravertebral tumors. Elderly patients may also exhibits varicose ulcers.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…(7,36). Therefore, the indications for a total splenectomy should be restraint to very few cases, while a conservative surgery should be the first option for the largest part of the patients.…”

Section: Therapy Outcomesmentioning

confidence: 99%

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Hereditary Spherocytosis - Diagnosis, Surgical Treatment and Outcomes. A Literature Review

Manciu¹,

Matei²,

Trandafir³

2017

chr

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RezumatSferocitoza ereditarã este o maladie congenitalã, caracterizatã prin anemie hemoliticã, ce afecteazã membranele eritrocitelor. Manifestãrile clinice variazã de la forme aproape asimptomatice la forme severe, ce necesitã transfuzii. Diagnosticul se bazeazã pe examenul clinic, hemograma cu numãrul reticulocitelor, prezenţa unui istoric familial şi teste de laborator specific, cum ar fi testul EMA (eosin-5-maleimide binding test) sau testul AGLT (Acidified Glycerol Lysis Time). Splenectomia este consideratã tratamentul standard în formele moderate pânã la severe de boalã. Totuşi, este cunoscut faptul cã splenectomia totalã expune pacientul la complicaţii infecţioase, uneori letale, ceea ce a determinat indicarea acestei metode cu precauţie. Astfel splenectomia subtotalã sau parţialã a devenit o alternativã de tratament fezabilã. Aceasta reduce distrugerea eritrocitelor, în timp ce conservã funcţia imunã a splinei. Majoritatea studiilor au arãtat beneficii certe, pe termen scurt, dupã splenectomie, în cazul acestor pacienţi. Totuşi, pânã în prezent, rezultate pe termen lung certe, adicã pe o perioadã de peste 5 ani de urmãrire postoperatorie, încã lipsesc.Cuvinte cheie: sferocite, hemoliză, citometrie în flux, splenectomie, rezultate pe termen lung AbstractHereditary spherocytosis (HS) is a disease affecting the red blood cells membrane and belongs to the congenital hemolytic anemias. The clinical spectrum ranges from asymptomatic patients to severe forms requiring transfusions in early childhood. The diagnosis can be based on the physical examination, complete red blood cell count, reticulocytes count, medical history and specific tests, preferentially the EMA test (eosin-5-maleimide binding) test and AGLT (Acidified Glycerol Lysis Time). Splenectomy is considered the standard surgical treatment in moderate and severe forms of hereditary spherocytosis. Total splenectomy exposes the patient to a life -long risk of potentially lethal infections and thus, its usage was reconsidered. Because of this reason, a feasible alternative is the partial splenectomy. The use of partial splenectomy aims to retain splenic immunologic function, while at the same time to decrease the rate of hemolysis. The long -term outcomes of patients with total or subtotal splenectomy for congenital hemolytic anemia, still remain unclear, but the majority of the studies showed a qualitative resolution of anemia and reduction of transfusion rate. Despite the well known advantages of conservative surgery, the optimal choice of treatment and outcomes should be confirmed with the patient.

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Section: Therapy Outcomesmentioning

confidence: 86%

Section: Clinical Presentationmentioning

confidence: 99%

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Hereditary Spherocytosis - Diagnosis, Surgical Treatment and Outcomes. A Literature Review

Manciu¹,

Matei²,

Trandafir³

2017

chr

View full text Add to dashboard Cite

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“…However, some authors, in other surgical procedures, demonstrated that in high‐volume centres, especially with a multidisciplinary use of the robotic platform, such as our tertiary care hospital, capital and maintenance costs are decreased about 35% . Lastly, to obtain a effective cost:benefit ratio, patient selection as well as procedure selection is mandatory , as we have done for type IV HH.…”

Section: Discussionmentioning

confidence: 99%

Robotic giant hiatal hernia repair: 3 year prospective evaluation and review of the literature

Morelli

Guadagni

Mariniello

et al. 2014

Int J Med Robotics Comput Assist Surg

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“…Minimal invasive surgery (MIS) is feasible and safe with growing popularity in different clinical practices (1)(2)(3)(4)(5). Laparoscopic and robotic splenectomies are subgroups of MIS and have been increased due to good exposure of the surgical field, less bleeding, postoperative abdominal pain and shorter length of the hospital stay (6)(7)(8). Robotic or laparoscopic splenectomies (RLS) are performed usually for benign blood disorders, splenic cystic disease, and play a crucial role in the management of a many malignant lymphoproliferative disorders (9,10).…”

Section: Introductionmentioning

confidence: 99%

Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy

et al. 2020

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Laparoscopic versus robotic subtotal splenectomy in hereditary spherocytosis. Potential advantages and limits of an expensive approach

Cited by 41 publications

References 29 publications

Hereditary Spherocytosis - Diagnosis, Surgical Treatment and Outcomes. A Literature Review

Hereditary Spherocytosis - Diagnosis, Surgical Treatment and Outcomes. A Literature Review

Robotic giant hiatal hernia repair: 3 year prospective evaluation and review of the literature

Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy

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