General Surgery Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56# Nanlishi Road, Beijing, 100045, China.
Pathology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
BMC Surg. 2022 Jul 29;22(1):295. doi: 10.1186/s12893-022-01745-2.
Benign splenic lesions are rarely encountered. This study aimed to review the clinical characteristics and surgical outcomes in a case series of 30 pediatric patients.
From January 1st, 2001 to December 31st, 2021, 30 pediatric patients from a single center were consecutively included. Electronic medical records were reviewed and patients were followed up. Clinical presentations, imaging features, surgical procedures, pathological diagnoses, and prognoses were summarized. The lesion locations and 7-day postoperative platelet levels were compared between total and partial splenectomy patients.
Eighteen males and twelve females were included, with mean age at surgery 116.4 ± 43.6 months. The clinical presentations included abdominal pain (16/30), splenomegaly (6/30), skin petechia (2/30), hemolytic jaundice (1/30), and no symptoms (5/30). Pathological diagnoses included congenital epithelial cyst (CEC, 17/30), vascular malformation (8/30), sclerosing angiomatoid nodular transformation (SANT, 3/30), hamartoma (1/30), and leiomyoma (1/30). Patients undergone total splenectomy were more likely to have a lesion involving the hilum than those undergone partial splenectomy (68.4% vs 31.6%, P = 0.021). The 7-day postoperative platelet level was higher in total splenectomy patients than partial splenectomy patients (adjusted means 694.4 × 10/L vs 402.4 × 10/L, P = 0.002).
Various clinical characteristics of pediatric benign splenic lesions are summarized. The most common pathological diagnoses are congenital epithelial cyst and vascular malformation. Partial and total splenectomy result in good prognosis with a low recurrence rate, and the former is preferred to preserve splenic function if possible.
良性脾病变很少见。本研究旨在回顾 30 例儿科患者的病例系列，以评估其临床特征和手术结果。
自 2001 年 1 月 1 日至 2021 年 12 月 31 日，从单中心连续纳入 30 例儿科患者。回顾电子病历并进行随访。总结了临床表现、影像学特征、手术过程、病理诊断和预后。比较了全脾切除术和部分脾切除术患者的病变部位和术后 7 天血小板水平。
纳入 18 例男性和 12 例女性，平均手术年龄为 116.4±43.6 个月。临床表现包括腹痛（16/30）、脾肿大（6/30）、皮肤瘀点（2/30）、溶血性黄疸（1/30）和无症状（5/30）。病理诊断包括先天性上皮囊肿（CEC，17/30）、血管畸形（8/30）、硬化性血管样结节性转化（SANT，3/30）、错构瘤（1/30）和平滑肌瘤（1/30）。全脾切除术患者的病变累及门脉区的可能性高于部分脾切除术患者（68.4%比 31.6%，P=0.021）。全脾切除术患者术后 7 天血小板水平高于部分脾切除术患者（调整均值 694.4×10/L 比 402.4×10/L，P=0.002）。
总结了儿科良性脾病变的各种临床特征。最常见的病理诊断是先天性上皮囊肿和血管畸形。部分脾切除术和全脾切除术均有良好的预后和低复发率，如果可能，应优先保留脾脏功能。
