Technical Problems of Splenectomy in Hematological Diseases

SURGERY IN ONCOHEMATOLOGY , , ,

SR Karagyulyan, KI Danishyan, SA Shutov, MA Silaev

Hematology Research Center under the Ministry of Health of the Russian Federation, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Karen Ismailovich Danishyan, PhD, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; e-mail: ntanisian@gmail.ru

For citation: Karagyulyan SR, Danishyan KI, Shutov SA, Silaev MA. Technical Problems of Splenectomy in Hematological Diseases. Clinical oncohematology. 2017;10(1):101–7 (In Russ).

DOI: 10.21320/2500-2139-2017-10-1-101-107

ABSTRACT

The article focuses on the technical aspects of splenectomy (SE) in 1628 patients using two main techniques: laparoscopy (885 SEs) and laparotomy (743 SEs), with a description of various factors that influence the invasiveness and the success of the surgery. The fact is that in addition to the shape and size of an enlarged spleen, the technical complexity of the SE, especially in laparoscopic access depends on the following factors: perisplenitis, close presentation and fusion of the tail of the pancreas to the spleen, tumor infiltration of splenic vascular pedicle, branchy type of its structure, visceral obesity, compression of the splenic pedicle with enlarged and united lymph nodes. In most cases (60 %), there is a combination of several risk factors, thus making the surgery even more difficult. The indications for splenectomy, as well as its influence on the course of the main hematological disease are not considered in this paper.

Keywords: hematological disorders, splenectomy, laparoscopy, laparotomy.

Received: August 11, 2016

Accepted: November 14, 2016

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