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Total Splenectomy (total + splenectomy)

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Medical Sciences	100%

Selected Abstracts

HEPATOLOGY: Electromagnetic thermoablation to treat thrombocytopenia in cirrhotic and hypersplenic rats

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 9 2010
Roberto Zuchini
Abstract Background and Aim:, Thrombocytopenia due to hypersplenism is usually a serious condition in cirrhotic patients who have undergone invasive procedures. We designed a new treatment method using a high-frequency alternating electromagnetic force to treat the disease condition in a rat model. Methods:, Sprague,Dawley rats were given thioacetamide in drinking water and injected with methylcellulose intraperitoneally to create a cirrhotic hypersplenism model. Spleen volume was determined using the Carlson method. The Control Group consisted of 14 rats, 15 weeks old, that were used to determine the normal platelet count and normal spleen size. Experimental Group I, consisting of 15 rats, received electromagnetic thermoablation of their spleens, after which the spleen was returned to the abdomen. Group II consisted of 13 rats, receiving the same electromagnetic thermoablation as Group I, but the ablated portion was removed. Group III consisted of 14 rats receiving total splenectomies. Results:, Cirrhotic hypersplenism was confirmed during laparotomy and pathological examination. Spleen volume enlarged from 1513 ± 375 mm3 (Control Group) to 7943 ± 2822 mm3 (experimental groups). Platelet counts increased from 0.35 ± 0.21 × 106/mm3 to 0.87 ± 0.24 × 106/mm3 for Group I, from 0.52 ± 0.23 × 106/mm3 to 1.10 ± 0.20 × 106/mm3 for Group II, and from 0.47 ± 0.23 × 106/mm3 to 1.18 ± 0.26 × 106/mm3 for Group III. No rats died due to the treatment in any of the experimental groups. Conclusions:, Our animal model performed successfully and our proposed electromagnetic thermotherapy effectively treated thrombocytopenia due to cirrhotic hypersplenism. [source]

Partial splenic embolization in children with hereditary spherocytosis

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 1 2008
Barbara Pratl
Abstract Objectives:, Although total splenectomy is able to reduce clinical symptoms in patients with hereditary spherocytosis (HS), splenectomized patients are at risk to develop overwhelming bacterial infections and, to a lesser extent, thromboembolic complications. In contrast, partial splenectomy or partial splenic embolization (PSE) may also decrease the rate of hemolytic complications while maintaining residual splenic function. The aim of this study was to investigate the benefit of PSE in children with moderate to severe HS. Patients and methods:, We performed PSE via retrograde transfemoral access in eight children (four female, four male) with moderate to severe HS at a median age of 8 yr. HS-related complications before PSE included gallstones in six and aplastic crises in four children. One patient was transfusion-dependent. Results:, No acute side effects were seen during or after PSE. Median hemoglobin increased significantly from levels between 7.5 g/dL and 11.65 g/dL before PSE to levels between 8.4 g/dL and 13.35 g/dL after PSE (P = 0.012). Median splenic sizes before PSE ranged from 9.7 cm/m2 to 19.0 cm/m2 and significantly decreased to values between 4.4 cm/m2 and 15.65 cm/m2 during follow-up (P = 0.012). Conclusions:, PSE appears to be a safe, effective and feasible treatment option for the management of children with moderate to severe HS. [source]

Is splenectomy a dyslipidemic intervention?

MICROSURGERY, Issue 2 2009
Experimental response of serum lipids to different diets, operations
Spleen removal may be recommended during organ transplantation in ABO-incompatible recipients as well as for hypoperfusion of the grafted liver, besides conventional surgical indications, but elevation of serum lipids has been observed in certain contexts. Aiming to analyze the influence of two dietary regimens on lipid profile, an experimental study was conducted. Methods: Male Wistar rats (n = 86, 333.0 ± 32.2 g) were divided in four groups: group 1: controls; group 2: sham operation; group 3: total splenectomy; group 4: subtotal splenectomy with upper pole preservation; subgroups A (cholesterol reducing chow) and B (cholesterol-rich mixture) were established, and diet was given during 90 days. Total cholesterol (Tchol), high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and triglycerides were documented. Results: After total splenectomy, hyperlipidemia ensued with cholesterol-reducing chow. Tchol, LDL, VLDL, triglycerides, and HDL changed from 56.4 ± 9.2, 24.6 ± 4.7, 9.7 ± 2.2, 48.6 ± 11.1, and 22.4 ± 4.3 mg/dL to 66.9 ± 11.4, 29.9 ± 5.9, 10.9 ± 2.3, 54.3 ± 11.4, and 26.1 ± 5.1 mg/dL, respectively. Upper pole preservation inhibited abnormalities of Tchol, HDL, VLDL, and triglycerides, and LDL decreased (23.6 ± 4.9 vs. 22.1 ± 5.1, P = 0.002). Higher concentrations were triggered by splenectomy and cholesterol-enriched diet (Tchol 59.4 ± 10.1 vs. 83.9 ± 14.3 mg/dL, P = 0.000), and upper-pole preservation diminished without abolishing hyperlipidemia (Tchol 55.9 ± 10.0 vs. 62.3 ± 7.8, P = 0.002). Conclusions: After splenectomy, hyperlipidemia occurred with both diets. Preservation of the upper pole tended to correct dyslipidemia in modality A and to attenuate it in subgroup B. © 2008 Wiley-Liss, Inc. Microsurgery, 2009. [source]

Emergency laparoscopic splenectomy for haemoperitoneum because of ruptured primary splenic pregnancy: a case report and review of literature

ANZ JOURNAL OF SURGERY, Issue 1-2 2010
Federico Biolchini
Abstract Background:, Primary abdominal pregnancies are potentially life-threatening, particularly without an accurate preoperative diagnosis. Case:, A 41-year-old woman presented to the emergency room with 2 days-lasting left upper quadrant abdominal pain, irradiated to the left shoulder. An urine ,-human chorionic gonadotropin test was positive. Transvaginal sonography raised a suspicion of ectopic pregnancy. The patient was then submitted to abdominal laparoscopy that revealed no sign of active bleeding or ectopic pregnancy. Because of worsening of abdominal pain and progressive anaemia, the patient underwent abdominal ultrasound and multislice computerized tomography scan (TC) that showed the presence of a mass at the superior splenic pole with haemoperitoneum. The patient was taken to the operating room and submitted to a laparoscopic total splenectomy. The post-operative course was uneventful, and the patient was discharged 8 days after intervention. Conclusion:, Abdominal pregnancy should be considered in the differential diagnosis of acute abdomen in women of reproductive age. Abdominal ultrasound and computerized tomography studies must be performed before operative treatment if an ectopic pregnancy is suspected and no intrauterine gestational sac could be showed on transvaginal sonography. [source]