title: Splenic artery embolization using contour emboli before laparoscopic or laparoscopically assisted splenectomy.
abstract: The present study assessed preoperative splenic artery embolization using spherical embolic material, super absorbent polymer microspheres (SAP-MS), before laparoscopic or laparoscopically assisted splenectomy. Distal splenic artery embolization using 250 to 400 microm SAP-MS was performed in nine cases with ITP and in seven cases with the other diseases with splenomegaly. Laparoscopic or laparoscopically assisted splenectomies, including a hand-assisted procedure and the procedure involving left upper minilaparotomy, were done 2 to 4 hours after embolization. Conversion to traditional laparotomy was not required in any of the 16 cases, while conversion to 12-cm laparotomy was required in one case with massive splenomegaly. Mean operating time was 161 minutes, and mean intraoperative blood loss was 290 mL. No major postoperative complications were identified, and only one patient reported postembolic pain before surgery. Preoperative splenic artery embolization using painless embolic material, SAP-MS, would be effective for easy and safe laparoscopic or laparoscopically assisted splenectomy.
authors.affiliation: Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital, Osaka, Japan. y-yama@rgmc.izumisano.Osaka.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Iwase
authors.forename: Jun
authors.initials: J
authors.lastname: Higaki
authors.forename: Hyung-Eun
authors.initials: HE
authors.lastname: Yoon
authors.forename: Shoki
authors.initials: S
authors.lastname: Mikata
authors.forename: Minoru
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishitani
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hori
authors.forename: Wataru
authors.initials: W
authors.lastname: Kamiike
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010976:Platelet Count; D011108:Polymers / Q000627:therapeutic use*; D011300:Preoperative Care / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects*; D013157:Splenic Artery / Q000601:surgery*; D013163:Splenomegaly / Q000601:surgery*
chemical_list: D011108:Polymers