Splenectomy for hypersplenism caused by adult T-cell leukemia: Report of a case

Endo, Yuichi; Ohta, Masayuki; Shibata, Kohei; Kai, Seiichiro; Iwaki, Kentaro; Uchida, Hajime; Ogata, Masao; Ikewaki, Junji; Kashima, Kenji; Kitano, Seigo

doi:10.1007/s00595-008-3802-y

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…It is believed that the indications for a splenectomy for hypersplenism include a tendency toward thrombocytopenia (platelet counts <30 × 10 3 /mm 3 ), diffi culties with therapies for hepatocellular carcinoma due to thrombocytopenia, the induction and continuation of interferon therapy due to thrombocytopenia or of chemotherapy for splenic lymphoma with hypersplenism, 4 and a combination of hypersplenism with endoscopic treatment-resistant esophageal varices. 5 The present case thus involved indications for a splenectomy and, based on the total bilirubin value of 1.39, the patient was also indicated to undergo a limited resection.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous laparoscopic hand-assisted hepatectomy and splenectomy for liver cancer with hypersplenism: Report of a case

Ohno¹,

Furui²,

Hashimoto³

et al. 2011

Surg Today

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Hepatocellular carcinoma accompanied by portal hypertension and hypersplenism is difficult to treat medically and surgically due to pancytopenia and the development of collateral circulation. In this study, we were able to safely and simultaneously perform a laparoscopically-assisted splenectomy and partial hepatectomy. The characteristics of this procedure include: (1) the shared use of a medial wound made through laparoscopically-assisted surgery; (2) improved safety for manipulating areas that were difficult to observe with a camera in a case of splenomegaly; (3) a preventive ligation of the splenic artery; (4) improved hemostatic function using LigaSure Impact; and (5) hemorrhage control through manual manipulations and the Pringle maneuver during liver parenchymal transection. The surgery was safely performed using the above points.

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Section: Discussionmentioning

confidence: 99%

Simultaneous laparoscopic hand-assisted hepatectomy and splenectomy for liver cancer with hypersplenism: Report of a case

Ohno¹,

Furui²,

Hashimoto³

et al. 2011

Surg Today

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“…Although splenectomy has recently been proposed as an optional treatment for hypersplenism caused by ATL [24], the consensus policy includes chemotherapy, antiviral therapy and allogeneic hematopoietic stem-cell transplantation [25]. In specific cases, splenectomy may therefore be considered as a palliative treatment for pain relief.…”

Section: Discussionmentioning

confidence: 99%

Earlier Onset of δ-Retrovirus-Induced Leukemia after Splenectomy

et al. 2009

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Infection by δ-retroviruses such as human T-lymphotropic virus type 1 (HTLV-1) and bovine leukemia virus (BLV) is mostly asymptomatic. Indeed, only a minority (<5%) of δ-retrovirus infected hosts will develop either lymphoproliferative or neurodegenerative diseases after long latency periods. In fact, the host immune response is believed to tightly control viral replication but this assumption has not been definitely proven in vivo. Here, we provide direct experimental evidence demonstrating that integrity of the spleen is required to control pathogenesis. In the BLV model, we show that asplenia decreases efficiency of the immune response and induces an imbalance in cell dynamics resulting in accelerated onset of leukemia. These observations enlighten a potential threat in splenectomized HTLV-1 carriers and justify a regular preventive evaluation.

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“…Peripheral cytopenia in hypersplenism is reversible after splenectomy 10 . In addition, laparoscopic splenectomy (Lap‐sp.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Peripheral cytopenia in hypersplenism is reversible after splenectomy. 10 In addition, laparoscopic splenectomy (Lap-sp. ), which is less invasive, is becoming feasible for cirrhotic patients.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic splenectomy may be a superior supportive intervention for cirrhotic patients with hypersplenism

Tomikawa¹,

Akahoshi²,

Sugimachi³

et al. 2010

J of Gastro and Hepatol

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Background and Aims: To evaluate and compare laparoscopic splenectomy and partial splenic embolization as supportive intervention for cirrhotic patients with hypersplenism to overcome peripheral cytopenia before the initiation of and during interferon therapy or anticancer therapy for hepatocellular carcinoma. Methods: Between December 2000 and April 2008, 43 Japanese cirrhotic patients with hypersplenism underwent either laparoscopic splenectomy or partial splenic embolization as a supportive intervention to facilitate the initiation and completion of either interferon therapy or anticancer therapy for hepatocellular carcinoma. We reviewed the peri-and post-intervention outcomes and details of the subsequent planned main therapies. For interferon therapy, the rate of completion, the rate of treatment cessation and virological responses were evaluated. Anti-cancer therapies for hepatocellular carcinoma included liver resection, ablation therapy, intra-arterial chemotherapy, and transarterial chemoembolization. Results: All patients tolerated the operations well with no significant complications. The platelet count was significantly higher in the laparoscopic splenectomy group than in the partial splenic embolization group at 1 and 2 weeks after the intervention. Interferon therapy was stopped in two patients in the partial splenic embolization group due to recurrent thrombocytopenia whereas all patients in the laparoscopic splenectomy group completed interferon therapy. The planned anticancer therapies were performed in all patients, and were completed in all patients without any problems or major complications. Conclusion: Laparoscopic splenectomy may be superior to partial splenic embolization as a supportive intervention for cirrhotic patients with hypersplenism. Future prospective, randomized controlled patient studies are required to confirm these findings.

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Splenectomy for hypersplenism caused by adult T-cell leukemia: Report of a case

Cited by 5 publications

References 16 publications

Simultaneous laparoscopic hand-assisted hepatectomy and splenectomy for liver cancer with hypersplenism: Report of a case

Simultaneous laparoscopic hand-assisted hepatectomy and splenectomy for liver cancer with hypersplenism: Report of a case

Earlier Onset of δ-Retrovirus-Induced Leukemia after Splenectomy

Laparoscopic splenectomy may be a superior supportive intervention for cirrhotic patients with hypersplenism

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