通过腹腔镜脾脏部分切除术治疗儿童表皮样脾囊肿。

Salihou Aminou Sadjo, Christelle Destinval, Sophie Amenan Kan Kouassi-Dria, Julie Lienard, Aline Ranke, Olivier Larmure, Nicolas Berte, Vladimir Gomola, Jean-Louis Lemelle
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摘要

摘要:脾表皮样囊肿是一种罕见的儿童良性肿瘤,占脾脏所有囊性病变的 10%,是非寄生虫性脾囊肿中最常见的诊断方法。它可能是偶然发现的,也可能是在肿块或腹痛的影像检查后发现的。由于全脾切除术使患者面临脾切除术后感染的风险,腹腔镜脾部分切除术在过去二十年中越来越受欢迎,因为它保留了脾脏的免疫功能。由于出血风险较高,这项技术只能由训练有素的团队进行。作者报告了三例接受腹腔镜脾脏部分切除术的患者:一名无相关病史的 7 岁女孩,脾脏下极有一个 4.5 厘米大的表皮样囊肿;一名接受胰岛素治疗的 13 岁 1 型糖尿病男孩,脾脏上极有一个 7 厘米大的表皮样囊肿;一名无病史的 14 岁女孩,脾脏上极有一个 6 厘米大的表皮样囊肿。手术时间分别为2小时30分钟、3小时和4小时30分钟。术中失血量分别为 100 毫升、350 毫升和 300 毫升。每位患者的住院时间均为 6 天。围手术期未进行输血。平均随访时间为 21 个月(分别为 32 个月、21 个月和 10 个月),没有发生并发症或复发。
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Epidermoid Splenic Cyst in Children Treated by Laparoscopic Partial Splenectomy.

Abstract: Epidermoid splenic cyst is a rare benign tumour in children, accounting for 10% of all cystic lesions of the spleen and is the most common diagnosis of non-parasitic splenic cysts. Its discovery could be incidental or happen after an imaging workup for a mass or abdominal pain. Since total splenectomy exposes a patient to the occurrence of overwhelming post-splenectomy infection, laparoscopic partial splenectomy has been increasingly popular over the past two decades because it preserves the immune function of the spleen. This technique should only be performed by a well-trained team because of the high risk of bleeding. The authors report the cases of three patients who underwent laparoscopic partial splenectomy: a 7-year-old girl with no relevant history with a 4.5-cm epidermoid cyst involving the lower pole of the spleen, a 13-year-old boy, type 1 diabetic on insulin therapy, with a 7-cm epidermoid cyst of the upper pole of the spleen and a 14-year-old girl, with no previous history, with a 6-cm upper pole epidermoid splenic cyst. Operating times were 2 h 30 min, 3 h and 4 h 30 min, respectively. The intraoperative blood loss was 100 mL, 350 mL and 300 mL, respectively. The length of hospital stay was 6 days for each patient. No blood transfusion was performed perioperatively. With a mean follow-up duration of 21 months (32 months, 21 months and 10 months, respectively), no complication or recurrence occurred.

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