Eur J Pediatr Surg 2010; 20(5): 287-289
DOI: 10.1055/s-0030-1253403
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic Excision of Splenic Cysts: A Comparison to the Open Approach

S. J. Keckler1 , S. D. St. Peter2 , K. Tsao3 , G. W. Holcomb1
  • 1Children's Mercy Hospital, Department of Surgery, Kansas City, United States
  • 2Children's Mercy Hospital, Department of Surgery, Center for Prospective Trials, Kansas City, United States
  • 3University of Texas Medical School at Houston, Pediatric Surgery, Houston, United States
Further Information

Publication History

received December 07, 2009

accepted after revision March 01, 2010

Publication Date:
27 October 2010 (online)

Abstract

Purpose: The aim of this study was to evaluate the outcomes following excision of splenic cysts in children.

Methods: A retrospective chart review of all patients who underwent excision of a splenic cyst between 1990 and 2007 was performed. Age, cyst etiology, cyst size, preoperative imaging, and operative approach were evaluated. Outcome variables included length of postoperative hospitalization, cyst recurrence, postoperative imaging, the histologic lining of the cyst, and the need for additional procedures.

Results: During this 17-year period, 9 patients underwent excision of a splenic cyst. Four underwent an open operation and 5 had a laparoscopic procedure. In the open group, 2 patients underwent splenectomy, one patient had a partial splenectomy, and one cyst was aspirated and marsupialized. In the laparoscopic group, 4 patients underwent complete excision of the cyst and 1 underwent resection of the outer wall. The mean age was 12.3 years. Computed tomography was performed preoperatively in 8 patients and one child had an ultrasound study. The most common symptom was abdominal pain in 6 patients. Four patients had a history of recent abdominal trauma. The mean length of postoperative hospitalization was 2.75 days for the open group and 1.6 days for the laparoscopic cohort. One patient in the laparoscopic group had a recurrence. To date, no additional operations have been performed.

Conclusions: Laparoscopic splenic cyst excision is comparable to open cyst excision and results in a decreased length of postoperative hospitalization.

References

  • 1 Brown MF, Ross 3rd AJ, Bishop HC. et al . Partial splenectomy: The preferred alternative for the treatment of splenic cyst.  J Pediatr Surg. 1989;  24 694-696
  • 2 Calisti A, Perrotta ML, Moelle P. et al . Epithelial splenic cysts in children: Surgical treatment by cyst wall “peeling”.  Pediatr Surg Int. 2003;  19 300-302
  • 3 Czauderna P, Vajda P, Schaarschmidt K. et al . Nonparasitic splenic cysts in children: A multicentric study.  Eur J Pediatr Surg. 2006;  16 415-419
  • 4 De Caluwe, Phelan E, Puri P. Pure alcohol injection of a congenital splenic cyst: A valid alternative?.  J Pediatr Surg. 2003;  38 629-632
  • 5 Eraklis AJ, Kerry SV, Diamond LK. Hazard of overwhelming infection after splenectomy in children.  N Engl J Med. 1967;  276 1225-1229
  • 6 Fisher JC, Gurung B, Cowles RA. Recurrence after laparoscopic excision of nonparasitic splenic cysts.  J Pediatr Surg. 2008;  43 1644-1648
  • 7 Gianom D, Wildisen A, Hotz T. et al . Open and laparoscopic treatment of nonparasitic splenic cyst.  Dig Surg. 2003;  20 74-78
  • 8 Khan AH, Bensoussan AL, Ouimert A. et al . Partial splenectomy for benign cystic lesions of the spleen.  J Pediatr Surg. 1986;  21 749-752
  • 9 MacKenzie RK, Youngson GG, Mahomed AA. Laparoscopic decapsulation of congenital splenic cysts: A step forward in splenic preservation.  J Pediatr Surg. 2004;  39 88-90
  • 10 Mertens J, Pennickx F, DeWever I. et al . Long-term outcome after surgical treatment of nonparasitic splenic cysts.  Surg Endos. 2007;  21 206-208
  • 11 Musey PA, Roche B, Belli D. et al . Splenic cysts in pediatric patients – A report on 8 cases and review of the literature.  Eur J Pediatr Surg. 1992;  2 137-140
  • 12 Schier F, Waag KL, Ure B. Laparoscopic unroofing of splenic cysts results in a high rate of recurrence.  J Pediatr Surg. 2007;  42 1860-1863
  • 13 Touloukian RJ, Haharaj A, Ghoussoub R. et al . Partial decapsulation of splenic epithelial cysts: Studies on etiology and outcome.  J Pediatr Surg. 1997;  32 272-274
  • 14 Tsadkyannis DE, Mitchell K, Kozakewich HPW. et al . Splenic preservation in the management of splenic epidermoid cysts in children.  J Pediatr Surg. 1995;  30 1468-1470
  • 15 Tulman S, Holcomb III GW, Karamanoukian HL. et al . Pediatric laparoscopic splenectomy.  J Pediatr Surg. 1993;  28 689-692
  • 16 Upadhyaya P, St Peter SD, Holcomb 3rd GW. Laparoscopic splenopexy and cystectomy for an enlarged wandering spleen and splenic cyst.  J Pediatr Surg. 2007;  42 E23-E27

Correspondence

Dr. Georg W. Holcomb III

Children's Mercy Hospital

Department of Surgery

2401 Gillham Road

64108-4698 Kansas City

United States

Phone: +1 816 234 3578

Fax: +1 816 983 0885

Email: gholcomb@cmh.edu

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