Laparoscopic unroofing of splenic cysts results in a high rate of recurrences.
OBJECTIVE
Laparoscopic unroofing is described as an appropriate treatment modality of nonparasitic splenic cysts. However, we repeatedly encountered recurrences with this technique. Because splenic cysts are rare, we analyzed the combined experience of 3 German pediatric surgical departments.


METHODS
Between 1995 and 2005, primary and secondary nonparasitic splenic cysts were unroofed laparoscopically in 14 children (aged 5-12 years; median, 8.5 years). In 3 patients, the inner surface was coagulated with the argon beamer. In most children, the cavity was surfaced with omentum. In addition, in 4 patients the omentum was sutured to the splenic parenchyma.


RESULTS
No intraoperative complications occurred, and no inadvertent splenectomy or blood transfusions were necessary. However, in 9 children (64%) the cysts recurred at intervals ranging from 6 to 12 months (median, 12 months). Also, argon laser treatment of the surface resulted in recurrence.


CONCLUSIONS
Laparoscopic unroofing of true splenic cysts alone proved inadequate in this series. Either removal of the inner layer or partial splenectomy appears to be necessary to prevent recurrences.
Schier
Felix
F
Department of Pediatric Surgery, University Medical Centres, Mainz 55101, Germany. schier@kinderchir.klinik.uni-mainz.de
Waag
Karl-Ludwig
KL
Ure
Benno
B
D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003560:Cysts / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013156:Splenectomy / Q000379:methods; D013158:Splenic Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*