Subtotal laparoscopic splenectomy and esophagogastric devascularization for the thrombocytopenia because of portal cavernoma—case report

Vasilescu, C; Stanciulea, Oana; Popa, Marcel Sabin; Coliţă, Anca; C, Arion

doi:10.1016/j.jpedsurg.2008.02.005

Cited by 10 publications

(9 citation statements)

References 12 publications

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“…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%

“…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, 19, 21,...…”

Section: Resultsmentioning

confidence: 99%

“…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, 19, 21, 26, 27, 33], five‐trocar laparoscopic splenectomy ( n = 47) [11, 13, 31, 34, 41, 46, 49, 52], two‐trocar laparoscopic splenectomy ( n = 4) [39, 40], single‐incision laparoscopic splenectomy( n = 2) [12–29], and hand‐assisted laparoscopic partial splenectomy ( n = 1) [36]. Six studies described combined operations including 16 cases of cholecystectomy [6, 31, 32, 34], case of esophagogastric devascularization [35], and one case of hepatic hydatid cyst excision [29].…”

Section: Resultsmentioning

confidence: 99%

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Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review

Liu

Fan

2019

World j. surg.

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review

Liu

Fan

2019

World j. surg.

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“…The occurrence of vascular malformation in children suggests that a congenital defect is often a contributing factor, such as prior umbilical cannulation and infection. Inherited and acquired prothrombotic disorders (e.g., latent myeloproliferative disorder, protein C or protein S deficiency, and antiphospholipid syndrome) and thrombotic stimuli, such as pregnancy or oral contraceptives, intra-abdominal infection, and surgical procedures, have been observed in adults, while repeated abdominal infections, sepsis, abdominal invasive procedures, trauma, and congenital anomalies, with or without a prothrombotic state, have been alleged to lead to CTPV in children ( 16 – 19 ). After the exclusion of the aforementioned causes, the etiology of EHPVO remains obscure in up to 50% of patients ( 20 ).…”

Section: Etiologymentioning

confidence: 99%

Optimal Treatment for Patients With Cavernous Transformation of the Portal Vein

2022

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Cavernous transformation of the portal vein (CTPV) is a sequela of extrahepatic and/or intrahepatic portal vein obstruction caused by a combination of local and risk factors. It was ever taken as a relatively rare disease due to its scant literature, which was mainly based on clinical series and case reports. CTPV often manifests as gastroesophageal variceal bleeding, splenomegaly, and portal biliopathy after the long-term insidious presentation. It is unable for CTPV to be recanalized with anticoagulation because it is a complete obstruction of the mesentericoportal axis. Endoscopic therapy is mainly used for temporary hemostasis in acute variceal bleeding. Meso-Rex shunting characterized by portal-flow-preserving shunts has been widely performed in children with CTPV. The multitude of complications associated with CTPV in adults can be effectively addressed by various interventional vascular therapies. With the ubiquity of radiological examinations, optimal treatment for patients with CTPV becomes important. Multivisceral transplantation, such as liver-small intestinal transplantation, may be lifesaving and should be considered for patients with diffuse mesenteric venous thrombosis.

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“…In case of multiple publications by the same surgical team, to prevent data overlap when different variables were compared within group in each publication, only the more informative comparison was considered. Three articles were excluded from our analysis: a case report of 1 child 12 (our study focused on adults 18–80 years old); another case report 13 that addressed only 1 postoperative complication, gastric perforation, which was also mentioned in another article, 14 ; and a third article that did not report LSD. 15 …”

Section: Methodsmentioning

confidence: 99%

Laparoscopic Splenectomy and Azygoportal Disconnection: a Systematic Review

Jiang

Bai

Chen

et al. 2015

JSLS

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Background and Objectives:Given the technical difficulty of laparoscopic splenectomy and azygoportal disconnection (LSD), data are limited that compare the laparoscopic to the open procedure. As the technique becomes more widespread, questions regarding its safety, feasibility, and reproducibility must be addressed. This review assesses the current status of LSD.Methods:We conducted our literature review with a search of the PubMed database. All published series of 5 or more laparoscopic splenectomy and azygoportal disconnection procedures were examined. The demographic, intraoperative, and postoperative data analyzed included number of ports, conversion rate, operative duration, estimated intraoperative blood loss, postoperative hospital stay, and complications.Results:Fifteen articles met the review criteria. Of 412 laparoscopic procedures, traditional laparoscopic splenectomy and azygoportal disconnection (TLSD) was used in 322 patients (78.2%), a modified laparoscopic procedure (MLSD) in 79 (19.2%), and a single-incision laparoscopic procedure (SLSD) in 11 (2.7%). Compared with the traditional and single-incision laparoscopic procedures, the MLSD procedure was associated with shorter operative duration and less blood loss. Furthermore, although the incidence of postoperative portal vein system thrombosis was higher in the laparoscopic than in the open splenectomy with azygoportal disconnection (OSD) procedure, the LSD procedure was associated with less pulmonary infection and pleural effusion and fewer incisional and overall complications than the open procedure. The rate of conversion to an open procedure was 5.4%.Conclusions:LSD is feasible and safe for selected patients when performed by an expert laparoscopic surgeon. It has perioperative advantages over OSD, but studies with longer follow-up periods and larger samples of patients are needed.

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Subtotal laparoscopic splenectomy and esophagogastric devascularization for the thrombocytopenia because of portal cavernoma—case report

Cited by 10 publications

References 12 publications

Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review

Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review

Optimal Treatment for Patients With Cavernous Transformation of the Portal Vein

Laparoscopic Splenectomy and Azygoportal Disconnection: a Systematic Review

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