Perioperative spleen embolization as a useful tool in laparoscopic splenectomy for simple and massive splenomegaly in children: a prospective study

Veken, E. Van Der; Laureys, Marc; Rodesch, Georges; Steyaert, Henri

doi:10.1007/s00464-016-4838-5

Cited by 14 publications

(9 citation statements)

References 26 publications

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“… 29 Perioperative splenic artery embolization has been found to be useful and reduces the complications of massive spleen laparoscopic splenectomy. 30 Moreover, selective splenic artery embolization, carried out in steps, will reduce spleen size and alleviate cytopenias. 31 …”

Section: Surgical Approachmentioning

confidence: 99%

Recommendations regarding splenectomy in hereditary hemolytic anemias

et al. 2017

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Hereditary hemolytic anemias are a group of disorders with a variety of causes, including red cell membrane defects, red blood cell enzyme disorders, congenital dyserythropoietic anemias, thalassemia syndromes and hemoglobinopathies. As damaged red blood cells passing through the red pulp of the spleen are removed by splenic macrophages, splenectomy is one possible therapeutic approach to the management of severely affected patients. However, except for hereditary spherocytosis for which the effectiveness of splenectomy has been well documented, the efficacy of splenectomy in other anemias within this group has yet to be determined and there are concerns regarding short- and long-term infectious and thrombotic complications. In light of the priorities identified by the European Hematology Association Roadmap we generated specific recommendations for each disorder, except thalassemia syndromes for which there are other, recent guidelines. Our recommendations are intended to enable clinicians to achieve better informed decisions on disease management by splenectomy, on the type of splenectomy and the possible consequences. As no randomized clinical trials, case control or cohort studies regarding splenectomy in these disorders were found in the literature, recommendations for each disease were based on expert opinion and were subsequently critically revised and modified by the Splenectomy in Rare Anemias Study Group, which includes hematologists caring for both adults and children.

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Section: Surgical Approachmentioning

confidence: 99%

Recommendations regarding splenectomy in hereditary hemolytic anemias

et al. 2017

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“…The HOR is widely used at many institutions, and its benefits have been reported in many fields, such as cardiac, vascular, emergency, and neurosurgery. [1][2][3][4][5] Furthermore, there are studies on the safety of intraoperative modulation in HOR in the fields of gynecology and gastrointestinal surgery. 12 In this study, IVR was performed by vascular surgeons or interventional radiologists.…”

Section: Discussionmentioning

confidence: 99%

“…A hybrid operating room (HOR) refers to an operating room that is fully equipped with medical imaging devices, such as high‐quality angiographic equipment. A HOR is widely used for cardiac, vascular, and neurosurgical procedures as it allows for precise intraoperative catheterization and navigation . The use of intraoperative interventional radiology (IVR) in the HOR has been reported in cases of severe trauma and nephrectomy; however, its use has rarely been reported in the field of gastrointestinal surgery.…”

Section: Introductionmentioning

confidence: 99%

“…A HOR is widely used for cardiac, vascular, and neurosurgical procedures as it allows for precise intraoperative catheterization and navigation. [1][2][3][4][5] The use of intraoperative interventional radiology (IVR) in the HOR has been reported in cases of severe trauma and nephrectomy 5,6 ; however, its use has rarely been reported in the field of gastrointestinal surgery. Moreover, the role of a HOR in gastrointestinal surgery is yet to be established.…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative modulation of arterial blood flow in a hybrid operating room: A report of three cases

Saitoh

Hara

Miyagi

et al. 2019

Clinical Case Reports

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“…Preoperative SAE makes splenectomy a safer procedure by reducing the intraoperative blood loss and the need for blood transfusion [ 9 ]. SAE before splenectomy improves the platelet count, reduces the size of the spleen and makes it softer [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Splenectomy for hypersplenism with or without preoperative splenic artery embolisation

et al. 2018

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BackgroundAlthough splenectomy is considered the preferred treatment for hypersplenism, intraoperative blood loss remains a common occurrence. We prospectively compared the perioperative and clinical outcome of splenic artery embolisation (SAE) before open splenectomy (OS) versus OS alone in two concurrent patient groups.MethodsFrom January 2016 to January 2018, 50 patients with hypersplenism underwent combined SAE and OS (study group). For comparison, we considered 50 age- and gender-matched case controls undergoing OS without prior SAE during the same period (control group). Perioperative and clinical outcomes were compared between the two groups. Mann–Whitney U test, Student’s t-test, χ2 or Fisher’s exact test were used as appropriate.ResultsNo significant differences were found between the two groups for age, gender and laboratory investigations (p ≥ 0.250). Mortality rate was zero in both groups. No patients of the study group needed perioperative blood transfusion in comparison with patients of the control group (p = 0.003). A significant increase in platelet count was noted in the study group after SAE compared to the control group (p = 0.024). No significant differences between the two groups were observed for operating time, postoperative complications and postoperative stay (p ≥ 0.237).ConclusionWe confirm that preoperative SAE in patients who undergo splenectomy for hypersplenism significantly reduces the need for blood transfusion in comparison to splenectomy without prior embolisation. Preoperative SAE is a safe procedure with neither morbidity nor mortality.

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Perioperative spleen embolization as a useful tool in laparoscopic splenectomy for simple and massive splenomegaly in children: a prospective study

Cited by 14 publications

References 26 publications

Recommendations regarding splenectomy in hereditary hemolytic anemias

Recommendations regarding splenectomy in hereditary hemolytic anemias

Intraoperative modulation of arterial blood flow in a hybrid operating room: A report of three cases

Splenectomy for hypersplenism with or without preoperative splenic artery embolisation

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