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Gasparetto A, Alonso J, Temple M, Parra D, Chiramel G, Chand R, Amaral J. Safety and Effectiveness of Sclerotherapy for Nonparasitic Splenic Cysts: A Systematic Review and Meta-Analysis. J Vasc Interv Radiol 2023; 34:2110-2119.e1. [PMID: 37652298 DOI: 10.1016/j.jvir.2023.08.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
PURPOSE To assess the reported safety and effectiveness of sclerotherapy for the treatment of nonparasitic splenic cysts through a systematic review and meta-analysis. MATERIALS AND METHODS A systematic search of PubMed MEDLINE, Embase, Web of Science, and the Cochrane Library through July 2023 was performed. Studies including at least 5 patients reporting percutaneous sclerotherapy of nonparasitic splenic cysts, initial and posttreatment cyst size, clinical symptoms as well as adverse events (AEs), and recurrence rates were included. A 0-8-point scale for case reports and case series was used to assess bias. Data were analyzed using random-effects meta-analysis. RESULTS Twenty-three of 833 citations were selected for full-text assessment, and 7 studies were included for a total of 99 patients. The methodological quality of the studies included scored 3-7. Composite analysis demonstrated 38% (95% CI, 23%-55%) rate of recurrence after treatment with significant heterogeneity; however, when assessed for a cyst size of <8 cm, recurrence dropped to 7% (95% CI, 2%-20%). Residual symptoms after treatment completion were present in 17% (95% CI, 7%-33%). Intraprocedural and postprocedural AE rates were 6% (95% CI, 3%-13%) and 6% (95% CI, 3%-12%) respectively. CONCLUSIONS Sclerotherapy of splenic cysts seemed to be safe, with a high rate of recurrence for cysts ≥8 cm.
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Affiliation(s)
- Alessandro Gasparetto
- Department of Interventional Radiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
| | - Jaime Alonso
- Department of Interventional Radiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Michael Temple
- Department of Interventional Radiology, St. Jude Hospital, University of Tennessee, Memphis, Tennessee
| | - Dimitri Parra
- Department of Interventional Radiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - George Chiramel
- Department of Interventional Radiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Rajat Chand
- Department of Interventional Radiology, UNC Hospitals, University of North Carolina, Chapel Hill, North Carolina
| | - Joao Amaral
- Department of Interventional Radiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Giurazza F, Marra P, Mosconi C, Corvino F, Corvino A, Niola R. Primary non-parasitic splenic cyst: US- and fluoroscopy-guided percutaneous management by alcohol sclerosis on six patients. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:1360-1367. [PMID: 36053957 DOI: 10.1002/jcu.23298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/13/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This manuscript aims to report on a retrospective analysis of six patients treated with combined US- and fluoroscopic-guided percutaneous alcohol sclerosis for primary non-parasitic splenic cysts. METHODS In this retrospective analysis, three females and three males affected by primary non-parasitic splenic cysts were included. All except one were symptomatic. Preoperative cyst diameter was in mean 113 mm (range: 67-210 mm). Ethanol 96% was adopted as sclerosant agent; the amount of ethanol injected corresponded to the 20%-30% of the cystic volume. US follow-up was planned at 2/4 weeks; MR follow-up was conducted almost at 6 months after the last treatment session. Technical success was considered as cyst disappearance or reduction of the maximum diameter <50 mm; clinical success, in those symptomatic cases, was considered as symptoms resolution or marked improvement. RESULTS Eleven procedures had been performed: one in three patients, three in two patients and two in one patient. Technical success was 83.3%; clinical success was 80%. Only one patient, with a preoperative cystic diameter of 210 mm and despite three treatment sessions, had an increase in the cystic size and did not report symptoms improvement. CONCLUSIONS In this sample, US-guided percutaneous alcohol sclerosis was a safe and effective spleen preserving option to treat primary non-parasitic splenic cysts.
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Affiliation(s)
- Francesco Giurazza
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, Naples, Italy
| | - Paolo Marra
- Department of Diagnostic Radiology, Giovanni XXIII Hospital, Milano-Bicocca University, Bergamo, Italy
| | - Cristina Mosconi
- Radiology Unit, Department of Specialized, Diagnostic and Experimental Medicine, DIMES, University Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Fabio Corvino
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, Naples, Italy
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", Naples, Italy
| | - Raffaella Niola
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, Naples, Italy
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Qingjiang C, Wang L, Chen X, Zhang Y, Zhang L, Zhu K, Xiong Q, Gao Z. Laparoscopic management of benign splenic tumors in children. WORLD JOURNAL OF PEDIATRIC SURGERY 2022; 5:e000419. [DOI: 10.1136/wjps-2022-000419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 07/04/2022] [Indexed: 11/03/2022] Open
Abstract
BackgroundThe splenic tumor is relatively rare in children. However, diagnosing and managing this disease remain controversial. This study aimed to evaluate the clinical characteristics and pathological features of benign splenic tumors and to explore the feasibility and safety of laparoscopic splenectomy in children.MethodsThe clinical data of all patients who were diagnosed with benign splenic tumors and admitted to our center between January 2014 and December 2020 were analyzed retrospectively. Factors that were documented included demographic criteria, clinical manifestations, preoperative examinations, surgical methods, histopathological characteristics, postoperative complications and outcomes.ResultsTotally, 24 consecutive patients with a mean age of 10.21±2.59 years were operated laparoscopically. Nine patients presented with recurrent abdominal pain, vomiting or backache. The remaining 15 cases were asymptomatic and were identified incidentally. Laparoscopic total splenectomy (LTS) was performed in 12 cases, laparoscopic partial splenectomy (LPS) in 9 cases and deroofing of splenic cyst in 3 cases. No significant differences were observed in operation time, intraoperative bleeding and postoperative abdominal drainage between the LTS and LPS groups. Histopathology examination reported 12 cases of splenic epithelial cyst, 5 cases of splenic lymphangioma or lymphatic malformation, 3 cases of splenic hamartoma, 3 cases of splenic littoral cell angioma and 1 case of splenic hemangioma. No postoperative complications and tumor recurrence were observed.ConclusionsIt is still difficult to precisely diagnose the splenic tumor preoperatively. Laparoscopic splenectomy is safe and feasible in treating the benign splenic tumors, and partial splenectomy is of great significance in preserving the immune function in children.
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Sangüesa Nebot C, Carazo Palacios E, Lorens Salvador R, Picó Aliaga S. Non-traumatic spleen disorders in children. Assessment by imaging. RADIOLOGIA 2019. [DOI: 10.1016/j.rxeng.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Sangüesa Nebot C, Palacios EC, Lorens Salvador R, Aliaga SP. El bazo pediátrico no traumático. Valoración por imagen. RADIOLOGIA 2019; 61:16-25. [DOI: 10.1016/j.rx.2018.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/27/2018] [Accepted: 07/29/2018] [Indexed: 02/07/2023]
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López JJ, Lodwick DL, Cooper JN, Hogan M, King D, Minneci PC. Sclerotherapy for splenic cysts in children. J Surg Res 2017; 219:1-4. [DOI: 10.1016/j.jss.2017.05.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/10/2017] [Accepted: 05/05/2017] [Indexed: 10/19/2022]
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Delforge X, Chaussy Y, Borrego P, Abbo O, Sauvat F, Ballouhey Q, Irtan S, Arnaud A, Ibtissam K, Panait N, Rodesch G, Steyaert H, Schneider A, Dubois R, Mesureur S, Haraux E, Buisson P. Management of nonparasitic splenic cysts in children: A French multicenter review of 100 cases. J Pediatr Surg 2017; 52:1465-1470. [PMID: 28185630 DOI: 10.1016/j.jpedsurg.2017.01.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/12/2016] [Accepted: 01/14/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND The management of nonparasitic splenic cysts (NPSC) remains controversial. Surgical resection is indicated for symptomatic or complicated forms, but no guidelines are available for asymptomatic NPSC. The aims of this study were to evaluate the management of NPSC in French hospitals and to analyze the results of management. METHODS We conducted a retrospective multicenter study from January 2004 to December 2014 in 16 university hospitals in France. Patients with a follow-up less than 6months were excluded. Data were extracted from the medical reports. RESULTS One hundred patients were included. Median follow-up was 12.8months. No complications were observed for NPSC smaller than 5cm. The size of NPSC increased significantly between the ages of 10 and 12years. Fifteen patients were under observation; 58.3% of cysts decreased in size and 41.7% remained stable. Among the 85 operated patients, no recurrence occurred in the splenectomy group, while 11 recurrences were observed in the cystectomy group (57.9%), 3 of which required redo surgery. CONCLUSIONS Observation is a safe treatment option for asymptomatic NPSC smaller than 5cm. Surgery is indicated for symptomatic patients, and can be proposed for asymptomatic NPSC larger than 5cm. Laparoscopic partial splenectomy is the technique of choice. Follow-up must be continued until the end of puberty. LEVELS OF EVIDENCE RATING Level III.
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Affiliation(s)
- Xavier Delforge
- Department of Pediatric Surgery, CHU Amiens, 80054, Amiens, France.
| | - Yann Chaussy
- Department of Pediatric Surgery, CHU Jean Minjoz, Besançon, France
| | - Paula Borrego
- Department of Pediatric Surgery, CH Lapeyronie-Arnaud de Villeneuve, Montpellier, France
| | - Olivier Abbo
- Department of Pediatric Surgery, CHU Purpan, Hôpital des enfants, Toulouse, France
| | - Frédérique Sauvat
- Department of Pediatric Surgery, CHR Felix Guyon, 97405 St Denis, Reunion Island, France
| | - Quentin Ballouhey
- Department of Pediatric Surgery, University Hospital, Limoges, France
| | - Sabine Irtan
- Department of Pediatric Surgery, Trousseau Hospital, Paris, France
| | - Alexis Arnaud
- Department of Pediatric Surgery, Hôpital sud, CHU Rennes, Rennes, France
| | - Kassite Ibtissam
- Department of Pediatric Surgery, Children University Hospital, Tours, France
| | - Nicoleta Panait
- Department of Pediatric Surgery, Aix-Marseille Université, APHM, CHU Hôpital Nord, Marseille, France
| | - Gregory Rodesch
- Department of Pediatric Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Bruxelles, Belgium
| | - Henri Steyaert
- Department of Pediatric Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Bruxelles, Belgium
| | - Anne Schneider
- Department of Pediatric Surgery, Hautepierre Hospital, University Medical Center, Strasbourg, France
| | - Rémi Dubois
- Department of Pediatric Surgery, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | | | - Elodie Haraux
- Department of Pediatric Surgery, CHU Amiens, 80054, Amiens, France
| | - Philippe Buisson
- Department of Pediatric Surgery, CHU Amiens, 80054, Amiens, France
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Varga I, Babala J, Kachlik D. Anatomic variations of the spleen: current state of terminology, classification, and embryological background. Surg Radiol Anat 2017. [DOI: 10.1007/s00276-017-1893-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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