Brandt Carlos T, Brandão S C S, Domingues A L C, Gondra L A, Viana R A
Department of Pediatric Surgery, Federal University of Pernambuco (UFPE), Brazil.
J Indian Assoc Pediatr Surg. 2012 Jul;17(3):104-6. doi: 10.4103/0971-9261.98120.
In children suffering from severe hepatosplenic schistosomiasis, the surgical protocol includes splenectomy and autoimplantation of spleen morsels in the major omentum, which has the potential of reducing the overwhelming postsplenectomy infection (OPSI). The purpose of the study was to evaluate the remaining splenosis, with the mean postoperative followup of 12.1 ± 5.6 years; to compare the efficacy of the 2 evaluation tools.
Nineteen patients underwent, when they were children, portal decompression and autoimplantation of spleen. After a mean age of 23.4 ± 5.3 years, they were investigated regarding the number of infections and OPSI. They had undergone hepatosplenic scintigraphy with labeled colloidal SnTc(99m) and abdominal ultrasound. It was considered efficient splenosis when the patients presented with 5 or more spleen nodules. The evaluation was performed by 3 observers.
None of the patients had increased infection rate or developed OPSI. Sixteen (84.2%) presented efficient splenosis.
The remaining postoperative splenosis was considered efficient in the majority of patients in the long-term followup; and nuclear medicine was considered the gold standard for splenosis evaluation.
在患有严重肝脾型血吸虫病的儿童中，手术方案包括脾切除术以及将脾脏碎块自体植入大网膜，这有可能降低脾切除术后暴发性感染（OPSI）。本研究的目的是评估残余脾组织再生情况，术后平均随访12.1±5.6年；比较两种评估工具的有效性。
19例患者在儿童时期接受了门静脉减压和脾脏自体植入术。平均年龄23.4±5.3岁时，对他们的感染次数和OPSI情况进行了调查。他们接受了99m锝标记胶体的肝脾闪烁扫描和腹部超声检查。当患者出现5个或更多脾脏结节时，认为脾组织再生有效。评估由3名观察者进行。
所有患者的感染率均未增加，也未发生OPSI。16例（84.2%）出现有效脾组织再生。
在长期随访中，大多数患者术后残余脾组织再生被认为是有效的；核医学被认为是脾组织再生评估的金标准。
