Tagaya Nobumi, Hamada Kiyoshige, Kubota Keiichi
Second Department of Surgery, Dokkyo University School of Medicine, Mibu, Tochigi, Japan.
Surg Laparosc Endosc Percutan Tech. 2007 Oct;17(5):465-8. doi: 10.1097/SLE.0b013e31806222aa.
We describe laparoscopic splenectomy for recurrent splenic cyst after laparoscopic marsupialization. The patient was a 24-year-old woman with a 20-cm palpable mass in the left upper quadrant. She had undergone laparoscopic marsupialization for splenic cyst 62 months previously. Abdominal ultrasonography and computed tomography revealed a huge cystic lesion of the spleen, and magnetic resonance imaging demonstrated multiple cystic lesions occupying almost the entire spleen. We performed laparoscopic splenectomy for the recurrent splenic cyst. The operation took 170 minutes. Histologic examination of the resected spleen revealed a hemangioma with cyst formation. The cyst wall consisted of fibrous tissue, covered by stratified cuboid or squamous epithelium. The patient had no abdominal symptoms during 13 months of follow-up. Postoperative follow-up examination by ultrasound or computed tomography is required after surgical treatment for splenic cyst to exclude the possibility of recurrence after preservation of the spleen.
我们描述了腹腔镜袋形缝合术后复发性脾囊肿的腹腔镜脾切除术。患者为一名24岁女性，左上腹可触及一个20厘米的肿块。她在62个月前因脾囊肿接受了腹腔镜袋形缝合术。腹部超声和计算机断层扫描显示脾脏有一个巨大的囊性病变，磁共振成像显示多个囊性病变几乎占据了整个脾脏。我们对复发性脾囊肿进行了腹腔镜脾切除术。手术耗时170分钟。切除脾脏的组织学检查显示为伴有囊肿形成的血管瘤。囊肿壁由纤维组织构成，表面覆盖有复层立方上皮或鳞状上皮。患者在13个月的随访期间无腹部症状。脾囊肿手术治疗后需要通过超声或计算机断层扫描进行术后随访检查，以排除保留脾脏后复发的可能性。
