Computed tomography to detect accessory spleens before laparoscopic splenectomy: is it necessary?

Quah, Conal; Ayiomamitis, Georgios D.; Shah, Amol; Ammori, Basil J.

doi:10.1007/s00464-010-1171-2

Cited by 28 publications

(24 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Laparoscopy does not increase the frequency of missing accessory spleens. 40 Consequently, laparoscopic splenectomy has been embraced as the "gold standard" 1,41 but should only be performed by experienced operators. 42 The conversion rate to open laparotomy ranges from 5%-15%.…”

Section: Prosmentioning

confidence: 99%

How I treat immune thrombocytopenia: the choice between splenectomy or a medical therapy as a second-line treatment

Ghanima

Godeau

Cines

et al. 2012

Blood

210

157

View full text Add to dashboard Cite

The paradigm for managing primary immune thrombocytopenia (ITP) in adults has changed with the advent of rituximab and thrombopoietin receptor agonists (TPO-RAs) as options for second-line therapy. Splenectomy continues to provide the highest cure rate (60%-70% at 5؉ years). Nonetheless, splenectomy is invasive, irreversible, associated with postoperative complications, and its outcome is currently unpredictable, leading some physicians and patients toward postponement and use of alternative approaches. An important predicament is the lack of studies comparing secondline options to splenectomy and to each other. Furthermore, some adults will improve spontaneously within 1-2 years. Rituximab has been given to more than 1 million patients worldwide, is generally well tolerated, and its short-term toxicity is acceptable. In adults with ITP, 40% of patients are complete responders at one year and 20% remain responders at 3-5 years. Newer approaches to using rituximab are under study. TPO-RAs induce platelet counts > 50 000/L in 60%-90% of adults with ITP, are well-tolerated, and show relatively little short-term toxicity. The fraction of TPO-RA-treated patients who will be treatment-free after 12-24 months of therapy is unknown but likely to be low. As each approach has advantages and disadvantages, treatment needs to be individualized, and patient participation in decision-making is paramount. (Blood. 2012;120(5):960-969)

show abstract

Section: Prosmentioning

confidence: 99%

How I treat immune thrombocytopenia: the choice between splenectomy or a medical therapy as a second-line treatment

Ghanima

Godeau

Cines

et al. 2012

Blood

210

157

View full text Add to dashboard Cite

show abstract

“…Perioperative CT for the detection and localization of accessory spleens may not be necessary. 22,23 …”

Section: Preoperative Planningmentioning

confidence: 99%

“…At this time there should be an examination for accessory spleens. [5][6][7]16,[21][22][23]30 Access to the splenic vessels can be gained by dividing the gastrosplenic ligament to gain entry into the lesser sac. Care should be taken when dividing short gastric vessels and the gastrosplenic ligament along the greater curvature of the stomach.…”

Section: Multiport Laparoscopic Splenectomymentioning

confidence: 99%

Minimally invasive splenectomy: an update and review

Gamme

Birch

Karmali

2013

cjs

View full text Add to dashboard Cite

“…The reported prevalence of accessory spleens identified in any location in the body varies in the literature, e.g., 10-30% [Gardikis et al, 2005], 10-44% [al-Ahmadi et al, 1998], 6.7% [Unver Dogan et al, 2011], 15.5% 377 [Quah et al, 2011], and 7.9% [Casaccia et al, 2006]. The variation in numbers can be partially explained by the fact that most of the studies are surgical or radiographic reports from findings in patients referred to the respective intervention and thus these samples are preselected.…”

Section: Discussionmentioning

confidence: 99%

Accessory Spleen in the Greater Omentum: Embryology and Revisited Prevalence Rates

Gill

Nasir

Douglin

et al. 2017

Cells Tissues Organs

View full text Add to dashboard Cite

Purpose: To investigate in a large sample the prevalence rates of accessory spleens located in the greater omentum and to explain the embryological background and the vascular supply of this rare congenital disorder. Methods: Evaluation of the presence of accessory spleens located in the greater omentum was performed in 5 different international anatomical centers investigating a total of 1,045 body donors. Arterial and venous blood supply and the precise location of the respective vasculature within the splenic ligaments are described based on dissection of this rare condition in a male specimen. Results: The reported prevalence rates from 5 different centers were: 0.5% (out of 380 body donors), 0% (out of 230 donors), 0% (out of 200 donors), 2% (out of 200 donors), and 0% (out of 35 donors). The cumulative prevalence rate obtained from 1,045 anatomical dissections was 0.6%. The identified accessory spleen measured 3 × 3 × 2.5 cm and was located in the left upper abdominal quadrant. A vascular stag 7.5 cm in length was identified within the gastro-splenic ligament, containing an artery and a vein piercing the greater omentum from posterior. Conclusion: An accessory spleen located in the greater omentum is a rare congenital disorder. Physicians should be aware of the fact that in patients without any representative symptom history a nodular mass located within the greater omentum could be an accessory spleen.

show abstract

Computed tomography to detect accessory spleens before laparoscopic splenectomy: is it necessary?

Abstract: Accessory spleens can be readily detected at laparoscopy in the vicinity of the spleen; preoperative CT scan for their detection and localization may not be necessary.

Cited by 28 publications

References 19 publications

How I treat immune thrombocytopenia: the choice between splenectomy or a medical therapy as a second-line treatment

How I treat immune thrombocytopenia: the choice between splenectomy or a medical therapy as a second-line treatment

Minimally invasive splenectomy: an update and review

Accessory Spleen in the Greater Omentum: Embryology and Revisited Prevalence Rates

Contact Info

Product

Resources

About