Open and Laparoscopic Treatment of Nonparasitic Splenic Cysts

Abstract

Background: Nonparasitic splenic cysts are rare. Therefore, there is no ‘evidence-based’ information regarding their optimal surgical management. In the last years the laparoscopic approach has gained increasing acceptance in splenic surgery. The aim of this study is to present our experience with the laparoscopic management of splenic cysts. Methods:The medical records of 7 patients with splenic cysts were reviewed retrospectively. Results: One patient had an open partial splenic resection. Five patients, 3 of them with a posttraumatic and 2 with an epidermoid splenic cyst, underwent laparoscopic unroofing of the cyst. In 4 of these cases the postoperative course was uneventful, whereas in 1 case the patient developed a cyst relapse soon postoperatively. Later on this patient successfully underwent an open partial splenic resection. The 7th patient had an explorative laparoscopy. The cyst was located intrasplenically, entirely covered with unaffected splenic parenchyma, and reached the splenic hilus. Therefore, a conversion to open partial splenectomy was performed. Conclusion: Open partial splenectomy and laparoscopic cyst wall unroofing are both effective tools in the management of splenic nonparasitic cysts. Surgeons must master both techniques as nowadays spleen-preserving techniques should be attempted in every case of splenic nonparasitic cyst.

Laparoscopic Partial Cystectomy for Non-Parasitic Splenic Cyst: A Case and Literature Review

“…There was no recurrence after 5 years of follow up. Several other studies have shown that laparoscopic partial cystectomy to be safe and effective (Till and Schaarschmidt, 2004;Mackenzie et al, 2004;Dan et al, 2010;Sellers and Starker, 1997;Gianom et al, 2003;Mertens et al, 2007). Results of our review support that laparoscopic partial cyst excision is safe and effective spleen preserving option in the treatment of NPSC.…”

Epithelial Cyst of the Spleen-A Rare Presentation

“…Surgical treatment for splenic cysts is indicted when symptomatic or large than 5 cm, as spontaneous resolution is less likely [12,15,16]. Treatment goals include elimination of cysts and prevention of recurrence.…”

Blužnies Cistos: Klinikinis Atvejis Ir Literatūros Apžvalga

“…blužnies cistos, kurias paprastai sukelia cistinis echinokokas (Echinoccocus granulosus), o Vidurio Europoje ir Šiaurės Amerikoje neparazitinės cistos esti dažnesnės [2,7]. Remiantis epidemiologiniais duomenimis, didžiąją neparazitinių cistų dalį sudaro potrauminės pseudocistos [8].…”

“…Pasak daugelio autorių, simptominės ir/ar 5 cm dydžio ir didesnės neparazitinės blužnies cistos turėtų būti gydomos chirurginiu būdu. Tokio dydžio blužnies cistos sietinos su didesne komplikacijų -cistos plyšimo, cheminio peritonito ir pūlinio formavimosi -rizika [7,9,11,12]. Kenney ir kolegų atliktame retrospektyviniame tyrime (115 pacientų) teigiama, jog dėl itin reto neparazitinių blužnies cistų komplikacijų dažnio neoperacinė gydymo taktika priimtina visoms neparazitinėms besimptomėms blužnies cistoms, nepriklausomai nuo jų dydžio.…”