Laparoscopic splenectomy in children – а 25-years of experience



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

   Introduction. Currently, the most successful option for treating benign hematological diseases of the spleen in children is splenectomy.
   Material and methods. In the article, the authors present their 25-year clinical experience in performing laparoscopic splenectomy in children with various diseases of the spleen. They discuss different techniques for surgical treatment of spleen diseases, features of preoperative preparation, current literature data.
   Results. The accumulated experience in laparoscopic surgeries for spleen removal, application of modern electrosurgical equipment and instruments for extracting tissues from the abdominal cavity have significantly reduced surgical time, improved cosmetic outcomes and quality of life of patients in the postoperative period. Somatostatin, prescribed right before the surgery and at the early postoperative period, prevents development of pancreatitis and erosive bleeding from the stump of the spleen pedicle in the vast majority of patients.
   Conclusion. The obtained catamnestic data demonstrate that laparoscopic surgery for spleen removal has its advantages. It is a safe, little-traumatic, effective and cosmetically good option for surgical spleen management in children.

About the authors

I. V. Poddubnyj

Scientific and Clinical Center for Children and Adolescents, FMBA; Yevdokimov Moscow State University of Medicine and Dentistry

Email: fake@neicon.ru
ORCID iD: 0000-0002-9077-6990

115409

127473

Moscow

Россия

K. N. Tolstov

Scientific and Clinical Center for Children and Adolescents, FMBA; Yevdokimov Moscow State University of Medicine and Dentistry

Author for correspondence.
Email: kntolstov@gmail.com
ORCID iD: 0000-0003-2412-414X

Kirill N. Tolstov, head of department

department of pediatric surgery

115409

127473

Moscow

Россия

V. O. Trunov

Scientific and Clinical Center for Children and Adolescents, FMBA

Email: fake@neicon.ru
ORCID iD: 0000-0002-7568-4297

115409

Moscow

Россия

M. Yu. Kozlov

Morozovskaya Children's City Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0002-9797-640X

119049

Moscow

Россия

E. V. Fedorova

Scientific and Clinical Center for Children and Adolescents, FMBA; Yevdokimov Moscow State University of Medicine and Dentistry

Email: fake@neicon.ru
ORCID iD: 0000-0002-5824-4732

115409

Moscow

Россия

M. M. Khanov

Scientific and Clinical Center for Children and Adolescents, FMBA

Email: fake@neicon.ru
ORCID iD: 0000-0003-3354-5018

115409

Moscow

Россия

A. S. Malashenko

Scientific and Clinical Center for Children and Adolescents, FMBA

Email: fake@neicon.ru
ORCID iD: 0000-0001-8167-5939

115409

Moscow

Россия

A. O. Mager

Scientific and Clinical Center for Children and Adolescents, FMBA; Yevdokimov Moscow State University of Medicine and Dentistry

Email: fake@neicon.ru
ORCID iD: 0000-0002-2498-0184

115409

127473

Moscow

Россия

A. S. Ranshakov

Scientific and Clinical Center for Children and Adolescents, FMBA; Yevdokimov Moscow State University of Medicine and Dentistry

Email: fake@neicon.ru
ORCID iD: 0000-0002-9431-3395

115409

127473

Moscow

Россия

V. V. Sytkov

Yevdokimov Moscow State University of Medicine and Dentistry

Email: fake@neicon.ru
ORCID iD: 0000-0001-6152-5693

127473

Moscow

Россия

References

  1. Wells T. S. Case of splenectomy. Lancet. 1888; 1: 724.
  2. Kaznelson P. Verschwinden der hamorrhagischen diathese bei einem falle von essentieller thrombopenie (frank) nach milzexstirpation: splenogene thrombolytische purpura. Wien Klin Wochnschr. 1916; 29: 1451–4.
  3. Delaitre B., Maignien B., Icard P. Laparoscopic splenectomy. British Journal of Surgery. 1992; 79 (12): 1334–4.
  4. Дронов А. Ф., Поддубный И. В., Котлобовский В. И., Залихин Д. В. Лапароскопическая хирургия при патологии селезёнки у детей. Эндоскопическая хирургия. 1998; 4: 18–22.
  5. Дронов А. Ф., Поддубный И. В., Смирнов А. Н., Котлобовский В. И., Чундокова М. А., Аль-Машат Н. А. Лапароскопическая спленэктомия при врождённой гемолитической анемии у детей. Хирургия. Журнал им. Н. И. Пирогова. 2002; 11: 14–8.
  6. Reddy V. S., Phan H. H., O’Neill J. A., et al. Laparoscopic versus open splenectomy in the pediatric population: a contemporary single-center experience. Am Surg. 2001; 67 (9): 859–63.
  7. Esposito C., Schaarschmidt K., Settimi A., et al. Experience with laparoscopic splenectomy. 2001; 36 (2): 309–11.
  8. Utria A. F., Goffredo P., Keck K., Shelton J. S., Shilyansky J., Hassan I. Laparoscopic Splenectomy: Has It Become the Standard Surgical Approach in Pediatric Patients? Journal of surgical research. August 2019; 240: 109–14.
  9. A Zhu J., Ye H., Wang Y., et al. Laparoscopic versus open pediatric splenectomy for massive splenomegaly. Surg Innov. 2011; 18 (4): 349–353.
  10. Dutta S., Price V. E., Blanchette V., Langer J. C. A laparoscopic approach to partial splenectomy for children with hereditary spherocytosis. Surgical Endoscopy. 2006; 20 (11): 1719–24.
  11. Chand B., Walsh R. M., Ponsky J., Brody F. Pancreatic complications following laparoscopic splenectomy. Surg Endosc. 2001; 15: 1273–6.
  12. Tsutsumi N., Tomikawa M., Akahoshi T., Kawanaka H., Ota M., 0Sakaguchi Y., et al. Pancreatic fistula after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis: Effect of fibrin glue and polyglycolic acid felt on prophylaxis of postoperative complications. Am J Surg. 2016; 212: 882–8.
  13. Mohammad Gharieb Khirallah, Fouad Hesham Salama, Mohammad Ahmad Arafa, Nagi Ebrahim Eldessoki, Mohammad Elshanshory. Analysis of Risk Factors of Pancreatic Injury during Elective Laparoscopic Splenectomy in Children. J Indian Assoc Pediatr Surg. 2019 Jul–Sep; 24 (3): 180–4.
  14. Rescorla F. J., West K. W., Engum S. A., et al. Laparoscopic splenic procedures in children: experience in 231 children. Ann Surg 2007; 246 (4): 683–7.
  15. Fujinaga A., Ohta M., Endo Y., Tada K., Kawamura M., Nakanuma H., Ogawa K., Watanabe K., Kawasaki T., Masuda T., Hirashita T., Toujigamori M., Inomata M. Clinical Significance of Splenic Vessels and Anatomical Features in Laparoscopic Splenectomy. J Laparoendosc Adv Surg Tech A. 2021 Jun; 31 (6): 632–7.
  16. Поддубный И. В., Евстафьева И. И., Исаев А. А., Толстов К. Н. Лапароскопическая спленэктомия у детей с микросфероцитарной анемией и β-талассемией. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2012; 2 (4): 11–7.
  17. Habermalz B., Sauerland S., Decker G., et al. Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc. 2008; 22 (4): 821–48.
  18. Rescorla F. J., Engum S. A., West K. W., Tres Scherer L.R. 3rd, Rouse T. M., Grosfeld J. L. Laparoscopic splenectomy has become the gold standard in children. Am Surg. 2002; 68 (3): 297–301.
  19. Murawski M., Patkowski D., Korlacki W., et al. Laparoscopic splenectomy in children-a multicenter experience. J Pediatr Surg. 2008; 43 (5): 951–4.
  20. Montorsi M., Zago M., Mosca F., Capussotti L., Zotti E., Ribotta G., Fegiz G., Fissi S., Roviaro G., Peracchia A., Pivi M., Perego R., Pezzuoli G. Efficacy of octreotide in the prevention of pancreatic fistula after elective pancreatic resections: A prospective, controlled, randomized clinical trial. Surgery. 1995; 117: 26–31.
  21. Ates U., Tastekin N. Y., Gollu G., Ergun E., Yagmurlu A. Laparoscopic splenectomy in pediatric age: long-term follow-up. Arch Argent Pediatr. 2017 Dec 1; 115 (6): 385–90. doi& 10.5546/aap.2017.eng.e385
  22. Поддубный И. В., Евстафьева И. И., Исаев А. А., Толстов К. Н. Симультантная холецистэктомия у детей с гемолитической анемией. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2013; 1: 66–70.
  23. Al-Mulhim A. S. Laparoscopic splenectomy for massive splenomegaly in benign hematological diseases. Surg Endosc. 2012; 26 (11): 3186–9.
  24. Al-Meflh W., Karadshah S., Khasawneh G., Qurah A. A., Abddullah B., Al Raymoony A., Al Saidah N., Gayet A. Laparoscopic Splenectomy in Children: Safety of Ligasure Usage. Med Arch. 2020 Apr; 74 (2): 131–3. doi: 10.5455/medarh.2020.74.131-133
  25. Englum B. R., Rothman J., Leonard S., et al. Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia. J Pediatr Surg. 2016; 51 (1): 122–7.
  26. Tripodi S. I., Shamberger R. C., Heeney M. M., Tubman V. N. Clinical and laboratory outcomes following total or partial splenectomy in patients with hereditary spherocytosis. Pediatr Hematol Oncol. 2019 Sep; 36 (6): 382–9. doi: 10.1080/08880018.2019.1637983
  27. Feng S., Qiu Y., Li X., Yang H., Wang C., Yang J., Liu W., Wang A., Yao X., Lai X. H. Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis. Pediatric Surgery International. 2016 Mar; 32 (3): 253–9. doi: 10.1007/s00383-015-3845-2
  28. Leone G., Pizzigallo E. Bacterial infections following splenectomy for malignant and nonmalignant hematologic diseases. Mediterr J Hematol Infect Dis. 2015; 7.
  29. Waghorn D. J. Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed. J. Clin. Pathol. 2001; 54: 214–8.
  30. Sandra L., Moffett P. C. Overwhelming postsplenectomy infection: Managing patients at risk. J. Am. Acad. Physician Assistants. 2009; 22 (7): 36–40.
  31. Spelman D., Buttery J., Daley A., Isaacs D., Jennens I., Kakakios A., et al. Guidelines for the prevention of sepsis in asplenic and hyposplenic patients. Intern Med J. 2008; 38: 349–56.
  32. Hansen K., Singer D. B. Asplenic hyposplenic overwhelming sepsis: Postsplenectomy sepsis revisited. Ped. Dev. Path. 2001; 4: 105–21.
  33. Морозов Д. А, Клюев С. А. Постспленэктомический гипоспленизм. Вестник Российской академии медицинских наук. 2015; 70 (4): 413–8. doi: 10.15690/vramn.v70.i4.1406
  34. Uhl W., Anghelacopoulos S. E., Friess H., Büchler M. W. The Role of Octreotide and Somatostatin in Acute and Chronic Pancreatitis. Digestion. 1999; 60 (2): 23–31.
  35. Buchler M., Friess H., Klempa I., Hermanek P., Sulkowski U., Becker H., Schafmayer A., Baca I., Lorenz D., Meister R., Kremes B., Wagner P., Witte J., Zurmayer E. L., Jaeger H. D., Rieck B., Dollinger P., Glaser K., Teichmann R., Konradt J., Gauss W., Dennler H. F., Welzel D., Beger H. G. The role of somatostatin analogue octreotide in the prevention of postoperative complications following pancreatic resection. The results of multicenter controlled trial. Am J Surg. 1992; 163: 125–30.
  36. Pederzoli P., Bassi C., Falconi M., Camboni M. G. Efficacy of octreotide in the prevention of complications of elective pancreatic surgery. Italian Study Group. Br J Surg. 1994 Feb; 81 (2): 265–9. doi: 10.1002/bjs.1800810237
  37. Deng X.-G., Maharjan A., Tang J., Qiu R.-L., Wu Y.-H., Zhang J., Deng J.-M. A modified laparoscopic splenectomy for massive splenomegaly in children with hematological disorder: a single institute retrospective clinical research. Pediatr Surg Int. 2012 Dec; 28 (12): 1201–9.
  38. Zhou J., Wu Z., Cai Y., Wang Y., Peng B. The feasibility and safty of laparoscopic splenectomy for massive splenectomy for massive splenomegaly: a comparative study. J Surg Res. 171 (1): 55–60.
  39. Сметанина Н. С., Коновалов Д. М., Клецкая И. С., Щербаков А. П., Талыпов С. Р., Меркулов Н. Н., Варфоломеева С. Р. Ангиома из клеток, выстилающих селезёночный синус. Педиатрия. Журнал им. Г. Н. Сперанского. 2017; 96 (3); 228–33.
  40. Толстов К. Н. Лапароскопическая спленэктомия у детей. Автореф. дис. канд. мед. наук. Москва; 2007.
  41. Skattum J., Naess P. A., Gaarder C. Non-operative management and immune function after splenic injury. Br J Surg. 2012 Jan; 99(Suppl 1): 59–65. doi: 10.1002/bjs.7764

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c)

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies