Evaluation of risk of splenosis during laparoscopic splenectomy in rat model

被引:11
作者
Espert, JJ
Targarona, EM
Bombuy, E
Setoain, J
Visa, J
Trias, M
机构
[1] Hosp Canta Creu & Sant Pau, Serv Gen & Digest Surg, Barcelona 08025, Spain
[2] Hosp Clin Barcelona, Serv Gen & Digest Surg, E-08036 Barcelona, Spain
[3] Hosp Clin Barcelona, Nucl Med Serv, E-08036 Barcelona, Spain
关键词
D O I
10.1007/s00268-001-0045-0
中图分类号
R61 [外科手术学];
学科分类号
摘要
Laparoscopic splenectomy (LS) is an alternative to open surgery, However, there is a theoretic risk of splenosis and abdominal cavity dissemination of splenic cells if the splenic capsule is broken, as seen by experimental evidence of tumoral cell mobilization by the pneumoperitoneum, We evaluated the features of splenosis after splenectomy operated via an open approach or under laparoscopic control in an experimental model in the rat, A total of 65 Sprague-Dawley rats were distributed in seven groups that included the open approach, CO2 pneumoperitoneum LS, or wall lift LS with or without a splenic graft, Splenic function was evaluated 90 day later through (1) scintigraphy with Tc-labeled heat-damaged erythrocytes; (2) determination of circulating "pitted" cells; and (3) analysis of the distribution of splenic pulp in the peritoneal cavity, Scintigraphy did not show viable residual tissue in any group after splenectomy; splenic activity in the splenic fossa was observed in 40% of the animals with grafts. Splenectomy increased the "pit" cell count, but it was reduced to normal values with a splenic graft. Necropsy showed normal splenic tissue in the splenic fossa in 100% of animals with a graft. Abdominal implants were observed significantly more frequently after CO2 LS than after the open surgery or a wall lift LS (80% vs. 20% vs, 30%; p < 0.05), In addition, trocar site implants were observed with CO2 LS (n = 3) or wall lift LS (n = 2), whereas there were no implants in the wound in the open group. We conclude that in an experimental rat model the pneumoperitoneum may facilitate abdominal splenosis after LS if the splenic capsule is ruptured or if splenic tissue spills compared with surgery without gas (open or laparoscopic).
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页码:882 / 885
页数:4
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