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保留脾下极的脾大部切除术治疗霍奇金淋巴瘤

Subtotal splenectomy preserving the inferior splenic pole for the treatment of Hodgkin's lymphoma.

作者信息

Petroianu Andy

机构信息

Department of Surgery of the Medical School of the Federal University of Minas Gerais, Brazil.

出版信息

Int J Surg Case Rep. 2017;36:1-3. doi: 10.1016/j.ijscr.2017.04.015. Epub 2017 Apr 25.

Abstract

INTRODUCTION

Splenectomy is helpful in the management of selected patients with Hodgkin's lymphoma (HL), but in some cases this procedure is accompanied by a greater morbidity and mortality mainly due to sepsis. This is the first published case of subtotal splenectomy preserving the inferior splenic pole without the maintenance of the splenic vascular pedicle.

PRESENTATION OF CASE

A 53-year-old man with HL refractory to chemo and radiotherapy associated to a very large spleen was successfully treated with subtotal splenectomy, preserving the inferior splenic pole supplied only by the left gastroepiploic and inferior splenic pole vessels. After an eleven year uneventful postoperative follow-up, the dimensions and function of the spleen are still preserved, and the disease is under control with chemo- and radiotherapy.

CONCLUSION

Subtotal splenectomy is efficacious to preserve the splenic functions and to prevent adverse effects of a large spleen on the treatment of Hodgkin's lymphoma confined to superior pole and producing significant abdominal symptoms and hematological effects.

摘要

引言

脾切除术有助于某些霍奇金淋巴瘤(HL)患者的治疗,但在某些情况下,该手术会伴随着更高的发病率和死亡率,主要原因是败血症。这是首例保留脾下极但未保留脾血管蒂的次全脾切除术的报道病例。

病例介绍

一名53岁男性,患有化疗和放疗难治性HL,伴有非常大的脾脏,成功接受了次全脾切除术,保留了仅由胃网膜左血管和脾下极血管供血的脾下极。经过11年的术后平稳随访,脾脏的大小和功能仍然保留,疾病通过化疗和放疗得到控制。

结论

次全脾切除术对于保留脾脏功能以及预防大脾脏对局限于脾上极并产生明显腹部症状和血液学影响的霍奇金淋巴瘤治疗的不良影响是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e172/5423331/7d1523c09590/gr1.jpg

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