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Partial splenectomy: A case series and systematic review of the literature

BACKGROUNDS/AIMS: Partial splenectomy (PS) is a surgical option for splenic mass, in order to reduce postoperative complications and preserve the splenic function. Despite this, data in literature is still scarce. The present study aimed to reveal our recent experience and provide a comprehensive ov...

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Autores principales: Esposito, Francesco, Noviello, Adele, Moles, Nicola, Cantore, Nicola, Baiamonte, Mario, Coppola Bottazzi, Enrico, Miro, Antonio, Crafa, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Association of Hepato-Biliary-Pancreatic Surgery 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981141/
https://www.ncbi.nlm.nih.gov/pubmed/29896572
http://dx.doi.org/10.14701/ahbps.2018.22.2.116
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author Esposito, Francesco
Noviello, Adele
Moles, Nicola
Cantore, Nicola
Baiamonte, Mario
Coppola Bottazzi, Enrico
Miro, Antonio
Crafa, Francesco
author_facet Esposito, Francesco
Noviello, Adele
Moles, Nicola
Cantore, Nicola
Baiamonte, Mario
Coppola Bottazzi, Enrico
Miro, Antonio
Crafa, Francesco
author_sort Esposito, Francesco
collection PubMed
description BACKGROUNDS/AIMS: Partial splenectomy (PS) is a surgical option for splenic mass, in order to reduce postoperative complications and preserve the splenic function. Despite this, data in literature is still scarce. The present study aimed to reveal our recent experience and provide a comprehensive overview of the feasibility and complications related to various surgical approaches. METHODS: Data of patients who underwent PS, between 2014 and 2017 were retrospectively reviewed. Literature was searched for studies reporting all types of PS in adult or adolescent patients. RESULTS: Five PS were performed in our department: two (40%) by laparoscopy and three (60%) by laparotomy. Two (40%) postoperative complications were detected, and in one of them, total splenectomy (TS) by laparotomy was finally required. There were no deaths or complications at last follow-up. Twenty studies including 213 patients were identified in the literature search. The rate of conversion from laparoscopic to open surgery was 3% (range, 5–50%) and in 3% of cases (range, 7–10%) PS was converted into total TS and the overall morbidity rate was 8% (range, 5–25%). In comparison to laparotomy, the conversion rate of laparoscopic approach to TS was 3.5% (vs. 1.4%) and a morbidity rate of 9.8% (vs. 4.3%). CONCLUSIONS: The present review shows that PS is a viable procedure in selected cases. The mini-invasive approach seemed to be feasible despite the presence of higher rate of complications than the open technique. In future, further studies on this topic are needed by involving more patients. Furthermore, it is proposed that the development of robotic surgery could make this approach the new gold-standard technique for spleen-preserving surgery.
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spelling pubmed-59811412018-06-12 Partial splenectomy: A case series and systematic review of the literature Esposito, Francesco Noviello, Adele Moles, Nicola Cantore, Nicola Baiamonte, Mario Coppola Bottazzi, Enrico Miro, Antonio Crafa, Francesco Ann Hepatobiliary Pancreat Surg Original Article BACKGROUNDS/AIMS: Partial splenectomy (PS) is a surgical option for splenic mass, in order to reduce postoperative complications and preserve the splenic function. Despite this, data in literature is still scarce. The present study aimed to reveal our recent experience and provide a comprehensive overview of the feasibility and complications related to various surgical approaches. METHODS: Data of patients who underwent PS, between 2014 and 2017 were retrospectively reviewed. Literature was searched for studies reporting all types of PS in adult or adolescent patients. RESULTS: Five PS were performed in our department: two (40%) by laparoscopy and three (60%) by laparotomy. Two (40%) postoperative complications were detected, and in one of them, total splenectomy (TS) by laparotomy was finally required. There were no deaths or complications at last follow-up. Twenty studies including 213 patients were identified in the literature search. The rate of conversion from laparoscopic to open surgery was 3% (range, 5–50%) and in 3% of cases (range, 7–10%) PS was converted into total TS and the overall morbidity rate was 8% (range, 5–25%). In comparison to laparotomy, the conversion rate of laparoscopic approach to TS was 3.5% (vs. 1.4%) and a morbidity rate of 9.8% (vs. 4.3%). CONCLUSIONS: The present review shows that PS is a viable procedure in selected cases. The mini-invasive approach seemed to be feasible despite the presence of higher rate of complications than the open technique. In future, further studies on this topic are needed by involving more patients. Furthermore, it is proposed that the development of robotic surgery could make this approach the new gold-standard technique for spleen-preserving surgery. Korean Association of Hepato-Biliary-Pancreatic Surgery 2018-05 2018-05-30 /pmc/articles/PMC5981141/ /pubmed/29896572 http://dx.doi.org/10.14701/ahbps.2018.22.2.116 Text en Copyright © 2018 by The Korean Association of Hepato-Biliary-Pancreatic Surgery http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Esposito, Francesco
Noviello, Adele
Moles, Nicola
Cantore, Nicola
Baiamonte, Mario
Coppola Bottazzi, Enrico
Miro, Antonio
Crafa, Francesco
Partial splenectomy: A case series and systematic review of the literature
title Partial splenectomy: A case series and systematic review of the literature
title_full Partial splenectomy: A case series and systematic review of the literature
title_fullStr Partial splenectomy: A case series and systematic review of the literature
title_full_unstemmed Partial splenectomy: A case series and systematic review of the literature
title_short Partial splenectomy: A case series and systematic review of the literature
title_sort partial splenectomy: a case series and systematic review of the literature
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981141/
https://www.ncbi.nlm.nih.gov/pubmed/29896572
http://dx.doi.org/10.14701/ahbps.2018.22.2.116
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