Laparoscopic subtotal splenectomy.
BACKGROUND
Since 1979, we have been studying subtotal splenectomy. This procedure was used in over 200 patients to treat splenic trauma, portal hypertension, myeloid metaplasia due to myelofibrosis, Gaucher disease, chronic lymphocytic leukemia, retarded growth, and sexual development associated with splenomegaly, and disorders of the pancreatic tail. On the basis of our clinic experience with laparoscopic splenectomy with and without splenic autotransplantation, open subtotal splenectomy, and after a training period with laparoscopic conservative splenic operations on animals, this communication presents laparoscopic subtotal splenectomy as a new treatment of severe pain due to ischemia of the spleen.


METHODS
Two patients with severe splenic pain due to ischemia provoked by vascular obstruction of the spleen were successfully treated by laparoscopic subtotal splenectomy, with preservation of the upper splenic pole supplied only by the gastrosplenic vessels.


RESULTS
This procedure was safely conducted with minor bleeding and no technical difficulties or complications. The postoperative follow-up of 5 and 21 months has been uneventful and the pain disappeared since the first postoperative day.


CONCLUSIONS
It is feasible and safe to perform subtotal splenectomy by laparoscopy. This procedure seems to be a good treatment for pain due to splenic ischemia.
Petroianu
Andy
A
Alfa Institute of Gastroenterology of the Hospital of Clinics of the Federal University of Minas Gerais, Belo Horizonte, Brazil. petroian@medicina.ufmg.br
Cabezas-Andrade
Marco Antonio
MA
Berindoague Neto
René
R
D000328:Adult; D005240:Feasibility Studies; D006801:Humans; D007511:Ischemia / Q000150:complications; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010146:Pain / Q000601:surgery; D012307:Risk Factors; D013154:Spleen / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery*