Sclerosing angiomatoid nodular transformation (SANT) of the spleen, a newly defined primary lesion of the spleen, is very rare. Immunohistochemistry is the only way to confirm the diagnosis of SANT. We present the clinical characteristics and postoperative outcomes of five SANT cases that underwent splenectomy from January 2007 to October 2010. Although SANT had specific imaging findings, differential diagnosis from other splenic tuomrs or malignant lesions preoperatively was difficult. The hand-assisted laparoscopic splenectomy was a useful and effective technique for the management and postoperative diagnosis of SANT. All SANT patients had good prognosis without recurrence after splenectomy.
Adult ; Angiomatosis ; diagnosis ; pathology ; surgery ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Spleen ; pathology ; surgery ; Splenic Neoplasms ; diagnosis ; pathology ; surgery

Animals ; Echinococcosis, Hepatic ; pathology ; surgery ; Humans ; Male ; Organ Sparing Treatments ; methods ; Spleen ; pathology

A 54-year-old woman presented with a huge palpable mass on left upper quadrant of the abdomen. After preoperative work-up, a cystic disease of pancreatic tail or accessory spleen was initially suspected. We performed exploratory laparotomy and resected both the spleen and a 15 x 11 cm-sized huge cystic mass containing a part of solid component which extended continuously to the pancreatic tail. The solid component, comprising the upper portion of the resected cyst, was reddish brown and granular like as normal splenic tissue. The inner surface of the cyst was smooth and was filled with yellowish white material. Histologic examination showed an epidermoid cyst originating in the accessory spleen of the pancreatic tail lacking hair or skin appendages.
Case Report ; Epidermal Cyst/surgery ; Epidermal Cyst/pathology* ; Female ; Human ; Magnetic Resonance Imaging ; Middle Age ; Pancreas/surgery ; Pancreas/pathology* ; Spleen/surgery ; Spleen/pathology* ; Splenic Neoplasms/surgery ; Splenic Neoplasms/pathology*

Adult ; Female ; Hamartoma ; complications ; diagnosis ; surgery ; Humans ; Kidney Calculi ; complications ; Spleen ; pathology ; surgery ; Splenectomy ; methods ; Splenic Diseases ; complications ; diagnosis ; surgery

Laparoscopic D2 lymphadenectomy for locally advanced upper-third gastric cancer(LAUGC) must follow the same lymph node dissection extent with open surgery. Following the surgical steps can make the operation process more smoothly and achieve en bloc resection. Laparoscopic spleen-preserving splenic hilar lymph node dissection is the difficult point during total gastrectomy for LAUGC. Selecting the right surgical approach, mastering spleen vascular anatomical types, and the cooperation of surgical team can help to shorten the learning curve of the operation. Although laparoscopic lymph node dissection for LAUGC is still in the exploratory stage, we believe that with the emergence of evidence-based medicine, it is expected to become one of the standard operations for LAUGC.
Gastrectomy ; Humans ; Laparoscopy ; methods ; Learning Curve ; Lymph Node Excision ; Lymph Nodes ; Spleen ; Stomach Neoplasms ; pathology ; surgery

Aged ; Female ; Histiocytoma, Malignant Fibrous ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Spleen ; chemistry ; pathology ; surgery ; Splenectomy ; Splenic Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Spleen-preservation has recently been emphasized in benign and borderline malignant pancreatic diseases requiring distal pancreatectomy. Reports to suggest that laparoscopic distal pancreatectomy is feasible and safe have been increasingly published. Robotic surgical system has been introduced and is expected to provide unique advantages in laparoscopic surgery. However, robot-assisted pancreatic surgery has not yet been performed by many surgeons. A 45-year-old female patient with abdominal discomfort was found to have pancreatic cyst in the body of the pancreas. Mucinous cystic tumor of the pancreas was the most favourable preoperative diagnosis. She underwent spleen-preserving laparoscopic distal pancreatectomy by using da Vinci surgical robot system. Splenic artery and vein were so tightly adherent to the pancreatic cyst that segmental resection of splenic vessels was required. Postoperative course was uneventful. She was able to come home in 5 days after surgery. Postoperative follow up color doppler ultrasound scan, taken on 2 weeks after surgery, showed minimal fluid collection around surgical field and no evidence of splenic infarction with good preservation of splenic perfusion. Robot-assisted spleen preserving distal pancreatectomy is thought to be feasible and safe. Several unique advantages of robotic system are expected to enhance safer and more precise surgical performance in near future. More experiences are mandatory to confirm real benefit of robot surgery in pancreatic disease.
Female ; Humans ; Laparoscopy/instrumentation/*methods ; Middle Aged ; Pancreatectomy/instrumentation/*methods ; Pancreatic Cyst/*surgery ; *Robotics ; Spleen/pathology/*surgery

This study aimed to examine the efficacy of the laparoscopic vs. traditional open splenectomy for hepatocellular carcinoma (HCC) with hypersplenism. Between 2002 and 2013, 51 Chinese HCC patients with hypersplenism underwent either simultaneous laparoscopic splenectomy plus anticancer therapies (Lap-S&A) (n=25) or traditional open splenectomy plus anti-cancer therapies (TOS&A) (n=26). The outcomes were reviewed during and after the operation. Anti-cancer therapies for HCC included laparoscopic hepatectomy (LH) and laparoscopic microwave ablation (LMA). The results showed that there was no significant difference in the operating time between the two groups, but the blood loss and blood transfusion were less, pain intensity after surgery was weaker, the time to first bowel movement, time to the first flatus and postoperative hospital stay were shorter, and the postoperative complication rate and the readmission rate were lower in the Lap-S&A group than in the TO-S&A group. Two patients in the Lap-S&A group and one patient in the TO-S&A group died 30 days after surgery. However, no significant difference in the mortality rate was noted between the two groups. It was concluded that simultaneous Lap-S&A holds the advantages of more extensive indications, lower complication incidence and less operative expenditure than conventional open approach and it is a feasible and safe approach for HCC with hypersplenism.
Adult ; Aged ; Carcinoma, Hepatocellular ; complications ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Hypersplenism ; complications ; pathology ; surgery ; Laparoscopy ; Liver ; pathology ; surgery ; Liver Neoplasms ; complications ; pathology ; surgery ; Male ; Middle Aged ; Spleen ; pathology ; surgery ; Splenectomy ; Treatment Outcome

Adult ; Calcinosis ; diagnostic imaging ; pathology ; surgery ; Cysts ; diagnostic imaging ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Lymphatic Vessel Tumors ; pathology ; Mucocele ; pathology ; Parasitic Diseases ; pathology ; Spleen ; diagnostic imaging ; Splenectomy ; Splenic Diseases ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo compare the number of harvested perisplenic hilar lymph nodes by laparoscopy-assisted total gastrectomy (LATG) and conventional open total gastrectomy (OTG) for advanced upper and middle gastric cancer.

METHODSThree hundred twelve patients with advanced gastric cancer treated in a single institution between Sept 2008 and Jan 2011 were included in this study. They were divided into two groups: the LATG group and OTG (D2) group. All the surgical operations were performed by one surgeon or under his supervision. The lymph node clearance outcomes of the patients treated by those two surgical procedures were analyzed.

RESULTSThe harvested lymph node numbers of the two groups were (29.57 ± 9.62) and (29.38 ± 11.22) respectively, statistically with no significant difference (P = 0.875). The numbers of lymph node dissected around the splenic area in the LATG group and OTG group (Section 10, 11 group) were (2.01 ± 1.34) and (1.33 ± 1.11), respectively, indicating a significant difference (P = 0.000). The numbers of lymph nodes dissected around the celiac region (Section 7, 8, 9, 11p and 12a(2) group) were (7.90 ± 3.41) and (7.22 ± 2.65), respectively, with a non-significant difference (P = 0.050). There were also no significant differences while comparing with the numbers of lymph nodes dissected in the cardiac area (group 1, 2), pyloric region (5, 6 group) and the greater and lesser omentum area (group 3 and 4) between the two groups (P = 0.605, P = 0.248, P = 0.262).

CONCLUSIONShort-term results of this study indicate that laparoscopy-assisted total gastrectomy (D2) is better than conventional open surgery in perisplenic hilar lymph node dissection.

Adult ; Aged ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Spleen ; Stomach ; Stomach Neoplasms ; pathology ; surgery