title: Management of nonparasitic splenic cysts in children: A French multicenter review of 100 cases.
abstract: BACKGROUND
  The management of nonparasitic splenic cysts (NPSC) remains controversial. Surgical resection is indicated for symptomatic or complicated forms, but no guidelines are available for asymptomatic NPSC. The aims of this study were to evaluate the management of NPSC in French hospitals and to analyze the results of management.
  
  
  METHODS
  We conducted a retrospective multicenter study from January 2004 to December 2014 in 16 university hospitals in France. Patients with a follow-up less than 6months were excluded. Data were extracted from the medical reports.
  
  
  RESULTS
  One hundred patients were included. Median follow-up was 12.8months. No complications were observed for NPSC smaller than 5cm. The size of NPSC increased significantly between the ages of 10 and 12years. Fifteen patients were under observation; 58.3% of cysts decreased in size and 41.7% remained stable. Among the 85 operated patients, no recurrence occurred in the splenectomy group, while 11 recurrences were observed in the cystectomy group (57.9%), 3 of which required redo surgery.
  
  
  CONCLUSIONS
  Observation is a safe treatment option for asymptomatic NPSC smaller than 5cm. Surgery is indicated for symptomatic patients, and can be proposed for asymptomatic NPSC larger than 5cm. Laparoscopic partial splenectomy is the technique of choice. Follow-up must be continued until the end of puberty.
  Level III.
authors.affiliation: Department of Pediatric Surgery, CHU Amiens, 80054, Amiens, France. Electronic address: xdelforge@gmail.com.
authors.forename: Xavier
authors.initials: X
authors.lastname: Delforge
authors.affiliation: Department of Pediatric Surgery, CHU Jean Minjoz, Besançon, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Chaussy
authors.affiliation: Department of Pediatric Surgery, CH Lapeyronie-Arnaud de Villeneuve, Montpellier, France.
authors.forename: Paula
authors.initials: P
authors.lastname: Borrego
authors.affiliation: Department of Pediatric Surgery, CHU Purpan, Hôpital des enfants, Toulouse, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Abbo
authors.affiliation: Department of Pediatric Surgery, CHR Felix Guyon, 97405 St Denis, Reunion Island, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Sauvat
authors.affiliation: Department of Pediatric Surgery, University Hospital, Limoges, France.
authors.forename: Quentin
authors.initials: Q
authors.lastname: Ballouhey
authors.affiliation: Department of Pediatric Surgery, Trousseau Hospital, Paris, France.
authors.forename: Sabine
authors.initials: S
authors.lastname: Irtan
authors.affiliation: Department of Pediatric Surgery, Hôpital sud, CHU Rennes, Rennes, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Arnaud
authors.affiliation: Department of Pediatric Surgery, Children University Hospital, Tours, France.
authors.forename: Kassite
authors.initials: K
authors.lastname: Ibtissam
authors.affiliation: Department of Pediatric Surgery, Aix-Marseille Université, APHM, CHU Hôpital Nord, Marseille, France.
authors.forename: Nicoleta
authors.initials: N
authors.lastname: Panait
authors.affiliation: Department of Pediatric Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Gregory
authors.initials: G
authors.lastname: Rodesch
authors.affiliation: Department of Pediatric Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Henri
authors.initials: H
authors.lastname: Steyaert
authors.affiliation: Department of Pediatric Surgery, Hautepierre Hospital, University Medical Center, Strasbourg, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Schneider
authors.affiliation: Department of Pediatric Surgery, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.
authors.forename: Rémi
authors.initials: R
authors.lastname: Dubois
authors.affiliation: Department of Pediatric Surgery, CHU Amiens, 80054, Amiens, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Mesureur
authors.affiliation: Department of Pediatric Surgery, CHU Amiens, 80054, Amiens, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Haraux
authors.affiliation: Department of Pediatric Surgery, CHU Amiens, 80054, Amiens, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Buisson
mesh_terms: D000293:Adolescent; D002648:Child; D015653:Cystectomy / Q000379:methods*; D003560:Cysts / Q000601:surgery*; D005260:Female; D005602:France; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods; D013158:Splenic Diseases / Q000601:surgery*
keywords: Children; Cystectomy; Laparoscopy; Nonparasitic splenic cysts; Partial splenectomy; Splenectomy