Merchant Taher Saifuddin, Kotawala Hussain
Department of Paediatric Surgery, Saifee Hospital, Mumbai, Maharashtra, India.
J Minim Access Surg. 2025 Jan 1;21(1):77-79. doi: 10.4103/jmas.jmas_212_23. Epub 2024 Jan 19.
With only seven reported cases until 2019 as noted by Lim et al ., cases of a wandering spleen (WS) accompanied by splenic cyst (SC) are exceptionally rare. Furthermore, both entities are notoriously 'silent' until they present as an emergency with complications, often warranting total splenectomy. Management of SC in a WS eventually depends on its clinical presentation, disease type and functional reservoir of the spleen. However, it is desirable to operate electively and perform a spleen salvage with splenic reposition surgery. Our case describes the first totally laparoscopic partial splenectomy and intraperitoneal fixation of the spleen by means of gastropexy for a large non-parasitic SC in a WS. Partial splenectomy instead of just a cystectomy tackles the risk of cyst recurrence, and a gastropexy over other splenic repositioning techniques would allow the spleen to remain as an intraperitoneal organ.
正如Lim等人所指出的，截至2019年，仅有7例游走脾（WS）合并脾囊肿（SC）的病例报告，极为罕见。此外，这两种情况在出现并发症导致紧急情况之前通常都“悄无声息”，往往需要进行全脾切除术。WS中SC的治疗最终取决于其临床表现、疾病类型和脾脏的功能储备。然而，选择性手术并通过脾复位手术挽救脾脏是可取的。我们的病例描述了首例通过胃固定术对WS中的大型非寄生虫性SC进行全腹腔镜下部分脾切除术和脾脏腹腔内固定术。采用部分脾切除术而非单纯囊肿切除术可解决囊肿复发的风险，与其他脾复位技术相比，胃固定术可使脾脏保留为腹腔内器官。
