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Int J Surg ; 20: 41-5, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26074292

RESUMO

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.


Assuntos
Equinococose/cirurgia , Esplenectomia/métodos , Esplenopatias/cirurgia , Adulto , Idoso , Animais , Celulose Oxidada/uso terapêutico , Feminino , Hemostáticos/uso terapêutico , Humanos , Laparoscopia/métodos , Laparotomia , Tempo de Internação , Ligadura , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Esplenectomia/economia , Grampeamento Cirúrgico
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