Splenectomy: Indications, hazards and alternatives

Cooper, M. J.; Williamson, R. C. N.

doi:10.1002/bjs.1800710302

Cited by 126 publications

(45 citation statements)

References 73 publications

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“…Thus, the knowledge of the variational anatomy of the spleen is of fundamental important. So, the aim of this study was to find out morphological structure of spleen 2 . In mammals, the spleen has three main functions.…”

Section: Introductionmentioning

confidence: 99%

Morphological Study of Spleen

G¹,

Pandit²,

S³

et al. 2016

IOSR

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Section: Introductionmentioning

confidence: 99%

Morphological Study of Spleen

G¹,

Pandit²,

S³

et al. 2016

IOSR

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“…The spleen was considered unnecessary for life for many centuries (Aristotle apud Cooper) 1 . Splenectomy was performed by surgeons regardless of the severity of the trauma or disease.…”

Section: Introductionmentioning

confidence: 99%

Subtotal splenectomy preserving the lower pole in rats: technical, morphological and functional aspects

Paulo

Kalil

et al. 2006

Acta Cir. Bras.

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Purpose:To assess the possibility of preserving the lower pole of the spleen, supplied by the inferior lobar vessels and segmental vessels, or by vessels of the gastrosplenic ligament, in subtotal splenectomy; to study the viability and function of the lower pole of the spleen. Methods: Thirty-six male Wistar rats were used in this study. Said animals weighed 273-390 g ( 355.2 ± 30.5 g ), and were randomly distributed into three groups. Group 1 comprised ten animals which were submitted to exploratory laparotomy with spleen manipulation (sham operation). Group 2 comprised 16 animals which were submitted to total splenectomy. Group 3 comprised ten animals which were submitted to subtotal splenectomy, preserving the lower pole of the spleen. Blood was collected from all animals before and 90 days after surgery to measure the levels of cholesterol and triglycerides. The animals were sacrificed 90 days after surgery. Spleens and remaining spleens were removed for macroscopic and microscopic examination. Results: Surgery was performed with no complications in all groups. Six animals died in group 2. Spleens of groups 1 and 2, and lower poles of group 3 were macroscopically viable. Apparent white pulp hyperplasia was observed in group 1. In group 3, slight inflammation and capsular fibrosis were observed at the incision site, as well as diffuse hemosiderosis in the red pulp. Average mass of remaining spleen was 35.84% ± 4.31%. No significant difference was observed between preoperative and late postoperative lipid levels in groups 1 and 3 (p > 0.05). Late postoperative lipid levels significantly increased in group 2. Conclusions: Preservation of the lower pole of the spleen (supplied by gastrosplenic vessels or inferior lobar vessels and segmental vessels) was possible with subtotal splenectomy. The lower pole was macroscopically and microscopically viable in all cases. Subtotal splenectomy preserving the lower pole prevented changes in lipid levels, which were observed in rats submitted to total splenectomy. Plasma lipid levels in rats submitted to subtotal splenectomy were similar to those observed in sham operated rats. Key words: Spleen. Splenectomy. Rats. RESUMOObjetivo: Avaliar a exequibilidade de preservação do pólo inferior suprido por vasos lobares inferiores e segmentares ou por vasos no ligamento esplenogástrico, na esplenectomia subtotal, e estudar a viabilidade e a função desse pólo. Métodos: Foram utilizados 36 ratos machos, Wistar, com peso entre 273 gramas e 390 gramas (M.A 355,2 ±30,5), distribuídos aleatoriamente em 3 grupos : grupo 1-10 animais submetidos à laparotomia com manipulação do baço (operação simulada); grupo 2-16 animais submetidos à esplenectomia total ; grupo 3-10 animais submetidos à esplenectomia subtotal com preservação do pólo inferior. Em todos os animais foi colhido sangue no pré-operatório e no 90º P.O para dosagem do colesterol e frações e triglicérides. Os animais foram mortos após 90 dias e o baço e o remanescente esplênico foram retirados para estudo macro e microscó...

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“…Until the middle of the 50's, surgeons performed total splenectomy no matter the severity of the disease or the spleen's trauma, once it was considered an organ with no functional importance 1,2 .…”

Section: Introductionmentioning

confidence: 99%

Effects of inferior splenic lobe pole fixation and gastrosplenic peritoneal membrane section on the vitality of the remanent of subtotal splenectomy in rats

et al. 2015

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PURPOSE:To investigate the vitality of the spleen lower pole after subtotal splenectomy with suture to the stomach and after posterior peritoneal gastro-splenic membrane section, using macro and microscopic evaluations. METHODS:Sixty Wistar rats were used in this study and were randomly distributed in the three groups: Group 1: (n=20), subtotal splenectomy with lower pole preservation, Group 2: (n=20) subtotal splenectomy with lower pole preservation and suture to the stomach, Group 3: subtotal splenectomy with lower pole preservation and posterior peritoneal gastrosplenic ligament section. The animals were sacrificed 45 days after the surgery and the spleen lower poles were removed for macroscopic and microscopic examination. RESULTS:All animals in this series survived. No macroscopic differences were encountered between the groups. Microscopic evaluation observed statistic difference concerning fibrosis between group 1 and 3 (p≤0.05), but the analysis for necrosis and inflammation presented no differences. CONCLUSION:Vitality of the spleen lower pole after subtotal splenectomy is minimally modified when it is fixed to the stomach or when the posterior peritoneal gastrosplenic ligament is resected.

show abstract

Splenectomy: Indications, hazards and alternatives

Cited by 126 publications

References 73 publications

Morphological Study of Spleen

Morphological Study of Spleen

Subtotal splenectomy preserving the lower pole in rats: technical, morphological and functional aspects

Effects of inferior splenic lobe pole fixation and gastrosplenic peritoneal membrane section on the vitality of the remanent of subtotal splenectomy in rats

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