- Meeting abstract
- Open Access
Laparoscopic splenectomy in an elderly patient with splenic limphoma and splenomegaly
© Antonelli et al; licensee BioMed Central Ltd. 2010
- Published: 19 May 2010
- Streptococcus Pneumoniae
- Splenic Artery
- Splenic Vein
- Laparoscopic Splenectomy
- Parietal Peritoneum
Limphomas represent a group of complex neoplastic diseases, characterized by hyperplasia and colonization of neoplastic lymphoid cells (T or B).
The aim of this study was to evaluate the result of laparoscopic surgery for the treatment of a splenic limphoma with splenomegaly in an elderly patient.
Patient of 69 years, lipothymia and anemia, Hb 11,2 gr/dl, leukocytis 7780/dl (neutrophilis 21,4%, lymphocytis 68,9%) PLTs 81000/dl, VES 34 mm / h (n.v. 2 -28).
Abdomen ultrasonography: spleen increased in volume (bipolar diameter 21,8 cm), bright liver. TC abdomen: spleen increased of volume, with inferior pole in Douglas.
Medullar biopsy: NH limphoma B-cell.
Patient was candidate to undergo to laparoscopic splenectomy.
Laparoscopy with open technique. Section of gastric breves vessels, closure of splenic artery. Section of freno-colic and freno-lienal ligaments, section of parietal peritoneum near the spleen.
Section of splenic vessels on the inferior pole and section of the grande omento. Section of splenic vein with vascular EndoGia. Legature with titanium clips and section of splenic artery. Lymph-nodes of splenic ilo are removed en-bloc with the spleen. Liver biopsy. Ombelicus-pubic laparotomy to take the specimen.
Laparoscopic surgery in elderly patients reduces post-operative pain, length of ileum and cardiopulmonary post-operative deficit [1–3]. In laparoscopic surgery the post-operative immune response is less reduced compared to open surgery, because of minor surgical stress and because fewer blood transfusions are required, above all in patients with lymphoma who have to undergo to a splenectomy with a higher risk of post-operative infections (Neisseria Meningiditis, Streptococcus Pneumoniae) [2–4].
In haematological disease, lapaparoscopic surgery is also very useful in order to have a diagnosis, with less post-operative complication than open surgery and, predominantly in very big size spleens, reduce the probability of spleen trauma during operation [3, 4].
- Walsh RM, Brody F, Brown N: Laparoscopic splenectomy for lymphoproliferative disease. Surg Endosc. 2004, 18 (2): 272-5. 10.1007/s00464-003-8916-0. Epub 2003 Dec 29PubMedView ArticleGoogle Scholar
- Rosen M, Brody F, Walsh RM, Tarnoff M, Malm J, Ponsky J: Outcome of laparoscopic splenectomy based on hematologic indication. Surg Endosc. 2002, 16 (2): 272-9. 10.1007/s00464-001-8150-6. Epub 2001 Nov 12.PubMedView ArticleGoogle Scholar
- Monteferrante E, Giunta A, Bigi L, Colecchia G, Della Valle E, Bonacini S, Pedrazzoli C, Ciarelli F, Colangelo E, Liberatore E, Nardi M, Basti M, Prati R: Splenectomy for hematologic disease. Mini-invasive versus traditional technique. Minerva Chir. 2001, 56 (3): 229-35.PubMedGoogle Scholar
- Carlini M, Giovannini C, Castaldi F, Cianciulli P, Sorrentino F, Mercadante E: Laparoscopic splenectomy in haematological diseases: short- and medium-term results in thirty initial cases. Chir Ital. 2009, 61 (4): 427-33.PubMedGoogle Scholar
This article is published under license to BioMed Central Ltd.