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巨大脾肿大的手术治疗。

Surgery for massive splenomegaly.

作者信息

Lemaire J, Rosière A, Bertrand C, Bihin B, Donckier J E, Michel L A

机构信息

Surgical Services Université de Louvain - Medical School at Mont-Godinne University Hospital Yvoir Belgium.

Biostatistics Unit Université de Louvain - Medical School at Mont-Godinne University Hospital Yvoir Belgium.

出版信息

BJS Open. 2017 Apr 6;1(1):11-17. doi: 10.1002/bjs5.1. eCollection 2017 Feb.

DOI:10.1002/bjs5.1
PMID:29951600
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5989945/
Abstract

BACKGROUND

Splenectomy for massive splenomegaly (spleen weight more than 1·5 kg) is commonly believed to be hazardous and to provide poor palliation. The aim of this cohort study was to investigate these issues and examine the many definitions of massive splenomegaly to see whether a better tool might be proposed for preoperative evaluation of these patients.

METHODS

Morbidity and long-term outcomes were assessed in consecutive patients. Relief of pressure-volume-related symptoms and sustainable independence from transfusion in patients were used to ascertain the impact of splenectomy.

RESULTS

Splenectomy was performed in 56 patients, mainly for non-Hodgkin's lymphoma and myeloproliferative diseases. Median spleen weight was 2·3 (range 1·5-6·0) kg. Mortality at 180 days was zero, and the postoperative complication rate was 25 per cent (17 complications in 14 patients). At 2 years, relief of pain was maintained in 33 of 34 patients, with sustained independence from transfusion in 15 of 19 patients with anaemia and nine of 11 with thrombocytopenia. Spleen weight correlated negatively with BMI (P = 0·036).

CONCLUSION

Splenectomy for massive splenomegaly is safe and provides effective palliation. Provisional cut-off points relating to spleen size and BMI help to identify patients benefiting from a splenectomy, even those in a critical state.

摘要

背景

对于巨脾（脾脏重量超过1.5千克）进行脾切除术，人们普遍认为该手术具有危险性且缓解效果不佳。这项队列研究的目的是调查这些问题，并审视巨脾的多种定义，以确定是否可以提出一种更好的工具用于这些患者的术前评估。

方法

对连续的患者评估其发病率和长期预后。通过缓解与压力-容量相关的症状以及患者不再依赖输血来确定脾切除术的影响。

结果

56例患者接受了脾切除术，主要病因是非霍奇金淋巴瘤和骨髓增殖性疾病。脾脏重量中位数为2.3（范围1.5 - 6.0）千克。180天时死亡率为零，术后并发症发生率为25%（14例患者出现17例并发症）。在2年时，34例患者中有33例疼痛得到缓解，19例贫血患者中有15例、11例血小板减少患者中有9例不再依赖输血。脾脏重量与体重指数呈负相关（P = 0.036）。

结论

对于巨脾进行脾切除术是安全的，并且能提供有效的缓解。与脾脏大小和体重指数相关的临时临界点有助于识别能从脾切除术中获益的患者，即使是处于危急状态的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/2fd3e98caa11/BJS5-1-11-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/f7dfefa4f24a/BJS5-1-11-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/19620803274b/BJS5-1-11-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/bb0112d236cf/BJS5-1-11-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/106ea7cde40f/BJS5-1-11-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/2fd3e98caa11/BJS5-1-11-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/f7dfefa4f24a/BJS5-1-11-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/19620803274b/BJS5-1-11-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/bb0112d236cf/BJS5-1-11-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/106ea7cde40f/BJS5-1-11-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b1/5989945/2fd3e98caa11/BJS5-1-11-g005.jpg

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World J Surg. 2021 Feb;45(2):465-479. doi: 10.1007/s00268-020-05839-x. Epub 2020 Nov 11.
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