Splenic Malignancy

Abstract

In open splenectomy series for patients with malignant diseases of the spleen, complication and mortality are much higher when compared to those patients undergoing open splenectomy for benign disease. The discussed series show no difference in endpoints when laparoscopy is used. Laparoscopic splenectomy for malignant disease confers significant benefit and rapid recovery for an otherwise at risk population.

Laparoscopic Versus Open Splenectomy for Nontraumatic Diseases

“…Hematologic diseases such as idiopathic thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP) with normal or only moderately enlarged spleens are still the most common indications for a laparoscopic splenectomy [3]. Malignancy is not a contraindication for a laparoscopic approach since it has recently been demonstrated that morbidity and mortality of patients who underwent laparoscopic splenectomy for benign or malignant diseases were not different and the long-term survival was not impaired [4].…”

A Glimpse into the Role and Effectiveness of Splenectomy for Isolated Metachronous Spleen Metastasis of Colorectal Cancer Origin: Long-Term Survivals Can Be Achieved

“…While an open technique in the setting of previously operated patients seems the first choice [87], other studies suggest that a laparoscopic approach can be successfully performed for isolated SM of solid cancers, with all the advantages of minimally invasive surgery [60,69,[99][100][101]. The oncological safety of a minimally invasive approach for spleen malignancies (including SM) was recently demonstrated [102]. A minimally invasive splenectomy is associated with low morbidity rates and almost nil mortality rates for both benign and malignant pathologies [102,103], although a malignant pathology is a risk factor for postoperative morbidity [104].…”

“…The oncological safety of a minimally invasive approach for spleen malignancies (including SM) was recently demonstrated [102]. A minimally invasive splenectomy is associated with low morbidity rates and almost nil mortality rates for both benign and malignant pathologies [102,103], although a malignant pathology is a risk factor for postoperative morbidity [104].…”

Laparoscopic Resection of an Undifferentiated Pleomorphic Splenic Sarcoma

“…It has been shown to have reduced morbidity and mortality rates compared with open splenec-tomy in many published series (morbidity 19% vs. 56%; mortality 2% vs. 18%). 19 Most reports include patients with benign diseases and small spleens. LS for malignant disease can be a greater challenge, because of the size of the spleen and the general condition of the patient.…”

“…LS for malignant disease can be a greater challenge, because of the size of the spleen and the general condition of the patient. Burch et al 19 compared the outcomes of LS for benign versus malignant neoplasms. They showed that there was no statistically significant difference identified between those undergoing LS for benign versus malignant disease in terms of length of stay, complication rate, or mortality.…”