title: Spleen hydatidosis treated by hemi-splenectomy: A low-morbidity, cost-effective management by a recently improved surgical technique.
abstract: BACKGROUND
  Splenic hydatidosis is a rare condition and is usually managed by total splenectomy, which is associated to various complications, including overwhelming post-splenectomy sepsis and thrombosis. Probably due to supposed technical difficulties, the partial splenectomy is rarely performed being often unknown to physicians, infectious disease specialists and surgeons.
  
  
  METHODS
  Demographic, clinical and surgical data were collected of four consecutive patients undergoing partial (or hemi-) splenectomy using an original, recently improved technique as a treatment for polar splenic hydatid cyst. The procedure implies a selective vascular ligation, a mechanical stapler-assisted section and haemostatic agents (Surgicel(®)) application on the cutting surface. Three patients were treated by laparotomy (including one affected by both liver and spleen localizations) whereas the last one was approached laparoscopically.
  
  
  RESULTS
  Partial splenectomy operative time reached 74 min (range: 60-94 min) and blood loss was 8 ml (range: 5-10 ml). Hospital stay was 5.6 days (range: 5-7 days). At a mean follow-up of 20 months (range: 12-36 months), outcomes were uneventful.
  
  
  CONCLUSIONS
  Partial splenectomy for hydatidosis is effective and safe. Physicians and surgeons should be aware of such an easy-to-catch option when dealing with benign splenic conditions, such as parasitic cysts. Cost-effectiveness, low morbidity and the possible prevention of splenectomy-related infectious complications should plead in favor of this technique in developing countries, where hydatidosis is endemic and post-splenectomy drugs and vaccines may be lacking.
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università degli Studi di Parma, Parma, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Costi
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università degli Studi di Parma, Parma, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Castro Ruiz
authors.affiliation: Service de Chirurgie Digestive, Centre Hospitalier Simone Veil, Eaubonne, France; Laboratoire d'éthique médicale et de médecine légale, Université Paris Descartes, Paris, France. Electronic address: spleen2008@live.fr.
authors.forename: Alban
authors.initials: A
authors.lastname: Zarzavadjian le Bian
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università degli Studi di Parma, Parma, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Scerrati
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università degli Studi di Parma, Parma, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Santi
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università degli Studi di Parma, Parma, Italy; Unità operativa di Chirurgia Generale, Ospedale di Fidenza, Fidenza, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Violi
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002483:Cellulose, Oxidized / Q000627:therapeutic use; D004443:Echinococcosis / Q000601:surgery*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy; D007902:Length of Stay; D008026:Ligation; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D013156:Splenectomy / Q000191:economics / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery*; D017792:Surgical Stapling
chemical_list: D002483:Cellulose, Oxidized; D006490:Hemostatics; C013695:Surgicel
keywords: Haemostatic agents; Partial splenectomy; TA stapler