Musy P A, Roche B, Belli D, Bugmann P, Nussle D, Le Coultre C
Clinique de Chirurgie Pédiatrique, Hôpital Cantonal Universitaire, Genève, Suisse.
Eur J Pediatr Surg. 1992 Jun;2(3):137-40. doi: 10.1055/s-2008-1063422.
8 cases of splenic cysts are reported: treatment was surgical in 4 large cysts (greater than 5 cm, 3 epidermoids and 1 pseudocyst), and non-operative in 4 small cysts (less than 5 cm, 3 post-traumatic pseudocysts and 1 congenital cyst, probably epidermoid). Follow-up was over a period of 3 months to 7 years. 3 among the 4 post-traumatic pseudocysts were followed up by ultrasound until resolution (3 months to 3 years), and 1 large pseudocyst was operated on due to rupture following benign trauma. 3 large cysts were epidermoid in origin, 1 was electively operated, and 2 were discovered and operated on because of complications (rupture, infection). Only one total splenectomy was performed; surgery preserved the spleen in all other cases; but 1 epidermoid cyst presents now with a recurrence. Based on this experience, we suggest frozen section of the cyst wall during surgery, to decide the type of partial splenectomy to be performed: total cystectomy or marsupialization.
报告了8例脾囊肿：4例大囊肿（直径大于5cm，3例表皮样囊肿和1例假性囊肿）采用手术治疗，4例小囊肿（直径小于5cm，3例创伤后假性囊肿和1例先天性囊肿，可能为表皮样囊肿）采用非手术治疗。随访时间为3个月至7年。4例创伤后假性囊肿中的3例通过超声随访直至囊肿消失（3个月至3年），1例大假性囊肿因良性创伤后破裂而接受手术。3例大囊肿起源于表皮样囊肿，1例择期手术，2例因并发症（破裂、感染）被发现并接受手术。仅实施了1例全脾切除术；其他所有病例手术均保留了脾脏；但1例表皮样囊肿目前出现复发。基于这一经验，我们建议在手术期间对囊肿壁进行冰冻切片检查，以决定实施何种类型的部分脾切除术：全囊肿切除术或袋形缝合术。
