Subtotal splenectomy for the treatment of chronic lymphocytic leukemia

Petroianu, Andy

doi:10.1038/bcj.2015.16

Cited by 8 publications

(7 citation statements)

References 10 publications

(21 reference statements)

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“…Certainly, B-cell CLL should and must be treated with evidenced-based modalities and guidelines, but the suspicion for a neoplastic process should never delay an emergency trauma operation. Although other studies have discussed the topic of subtotal splenectomy for CLL, an extensive literature review has not revealed any previous case reports that present an emergency splenectomy in the context of blunt trauma with incidental CLL [15] . Thus, the lessons from this case are valuable to the surgical community since they reinforce the basic trauma principles that constitute the international standard of care.…”

Section: Discussionmentioning

confidence: 99%

Emergency splenectomy for trauma in the setting of splenomegaly, axillary lymphadenopathy, and incidental B-cell chronic lymphocytic leukemia: A case report

Oviedo

Glickman

2017

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Emergency splenectomy for trauma in the setting of splenomegaly, axillary lymphadenopathy, and incidental B-cell chronic lymphocytic leukemia: A case report

Oviedo

Glickman

2017

International Journal of Surgery Case Reports

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“…17 Others argue that a partial splenectomy may represent a better alternative since it achieves the same objectives without the adverse side effects of the total splenectomy. 18,19 Furthermore, the benefits may be transient following this procedure because the spleen regenerates and the clinical/laboratory findings can relapse. In this regard, the subtotal splenectomy, preserving the superior splenic pole supplied only by the splenogastric vessels, has also been suggested.…”

Section: Discussionmentioning

confidence: 99%

Selective Spleen Embolization of Splenomegaly to Improve Thrombocytopenia Facilitating Open Aortic Aneurysm Repair

Maras

Kontopodis

Dedes

et al. 2016

Vasc Endovascular Surg

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We present an 82-year-old man with a history of hairy cell leukemia, having an 11-cm abdominal aortic aneurysm, who also had severe thrombocytopenia (about 20 000 platelets/μL) and splenomegaly at presentation. The patient had unfavorable anatomy for endovascular aneurysm repair, and therefore, an open procedure was planned. To reduce risk for perioperative bleeding and optimize patient preoperative status, a staged approach was employed. Initially, several sessions of embolization of 2 splenic artery branches were performed with the intent to decrease spleen size and to increase platelet count thus decreasing the perioperative bleeding risk. Then, after successfully increasing platelet count (280 000 PLT/μL), open repair of the aneurysm was conducted. This case demonstrates that selective splenic embolization in patients with hypersplenism and subsequent thrombocytopenia who are in need for major surgery may achieve a significant rise in platelet count and optimize patient's preoperative status in order to avoid bleeding complications.

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“…In such cases, a subtotal splenectomy is recommended to alleviate the symptoms and to improve the results of chemotherapy, without reducing the patient's immune defences, followed by severe sepsis and precocious death due to an asplenic condition if a total splenectomy needs to be performed. The advances of imaging methods and imaging guided biopsies have been enough to define the stage of oncological diseases, including Hodgkin's and non-Hodgkin's lymphomas; therefore, surgical procedures must be avoided [21,26,27,28,29] .…”

Section: Splenic Diseases In the Elderlymentioning

confidence: 99%

The Spleen and Spleen Surgery in the Elderly

Petroianu

2018

International Journal of Hematology Research

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The spleen is a very important organ with many essential functions, not only in the defense of the organism, but also in its metabolic, immunological and haematological systems. The most common manifestations of the splenic disturbances include splenomegaly and a decrease in the number of blood elements. After the removal of the spleen, 2% of adults present severe sepsis, while more than 10% of the elderly are at risk of death due to septic conditions. Most splenic diseases can be treated conservatively. Operative procedures should be considered in special conditions, when all conservative options have been unsuccessfully depleted. Even in the presence of a severe trauma to the spleen or advanced haematological diseases, the best approach is a non-operative procedure. When the operation is unavoidable, partial and subtotal splenectomies or implants of autogenous splenic tissue onto the greater omentum should be performed. At least 25% of a normal spleen should be left with drainage to the portal system to preserve the complete efficacy of all splenic functions. The technological advances and the progressive development of new surgical devices are responsible for laparoscopy with or without robotic assistance. These surgical approaches lead to less pain, faster postoperative recovery and better cosmetic results, without decreasing the therapeutic efficacy. The conservative splenic approach, whether clinical or surgical, is the best way to prevent postsplenectomy infection, by preserving the spleen's role in immunity.

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Subtotal splenectomy for the treatment of chronic lymphocytic leukemia

Cited by 8 publications

References 10 publications

Emergency splenectomy for trauma in the setting of splenomegaly, axillary lymphadenopathy, and incidental B-cell chronic lymphocytic leukemia: A case report

Emergency splenectomy for trauma in the setting of splenomegaly, axillary lymphadenopathy, and incidental B-cell chronic lymphocytic leukemia: A case report

Selective Spleen Embolization of Splenomegaly to Improve Thrombocytopenia Facilitating Open Aortic Aneurysm Repair

The Spleen and Spleen Surgery in the Elderly

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