title: [Successful management using laparoscopic splenectomy for splenomegaly and thrombocytopenia caused by oxaliplatin-based chemotherapy for advanced rectal cancer].
abstract: We report a case of advanced rectal cancer treated with chemotherapy, for which laparoscopic splenectomy had been effective for thrombocytopenia. A 56-year-old man suffered from advanced rectal cancer with multiple lung metastases. He underwent Hartmann's procedure and received chemotherapy with FOLFOX and FOLFIRI with bevacizumab. After 3 years and 2 months, he also suffered from splenomegaly and thrombocytopenia. Laparoscopic splenectomy produced and increased the thrombocyte count, allowing for a restart of chemotherapy. Oxaliplatin-based chemotherapy might produce hepatic sinusoid injury and induce splenomegaly owing to portal hypertension. Laparoscopic splenectomy seemed to be useful for treating thrombocytopenia, and allowed the continuation of chemotherapy.
authors.affiliation: Dept. of Surgery, Seirei Sakura Citizen Hospital, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Koike
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ohshima
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Seiji
authors.initials: S
authors.lastname: Arita
authors.forename: Eiji
authors.initials: E
authors.lastname: Shinozaki
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D017809:Fatal Outcome; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D000077150:Oxaliplatin; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013156:Splenectomy; D013163:Splenomegaly / Q000139:chemically induced* / Q000601:surgery; D013921:Thrombocytopenia / Q000139:chemically induced*
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil