Laparoscopic Partial Splenectomy Assisted by Fluorescence in a 13-Year-Old Girl.
Laparoscopic Partial Splenectomy Assisted by Fluorescence in a 13-Year-Old Girl.
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DOI：
10.1055/s-0040-1716894
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发表时间：
2020-01
影响因子：
0.6
通讯作者：
de Agustin J
中科院分区：
文献类型：
--
作者：
Bada-Bosch I;Mata DP;de la Torre M;Ordóñez J;Blanco MD;de Agustin J
脾部分切除可保留良性脾病变如表皮样囊肿的免疫功能。确定残余脾脏的切除和灌注平面可能是困难的，特别是在中心位置的病变。我们报告一个13岁的女孩，在脾门附近有一个直径6厘米的症状性脾囊肿。腹腔镜脾部分切除术通过10毫米脐带入路和三个辅助5毫米端口进行。术中静脉注射吲哚菁绿（ICG） 0.2 mg/kg，引导仔细解剖脾门，夹紧上动脉分支后检查脾灌注情况。随后的ICG冲洗允许通过极静脉检查脾残余的周围血管返回。手术很顺利，出血量很少。随访的超声扫描显示一个灌注良好的小脾脏残余，无复发迹象。腹腔镜脾部分切除术对于良性脾肿瘤是可行的，尤其是外周性脾肿瘤。在解剖和技术复杂的部分脾切除术中，荧光技术有助于脾门的安全解剖、脾横切面的可视化和残余脾的灌注。
Partial splenectomy allows preserving immune function in benign splenic lesions such as epidermoid cysts. Determining the plane of resection and perfusion of the spleen remnant can be difficult, especially in centrally located lesions. We present a 13-year-old girl with a symptomatic splenic cyst of 6 cm in diameter located next to the splenic hilum. Laparoscopic partial splenectomy was performed through a 10-mm umbilical approach and three accessory 5-mm ports. Intraoperative intravenous injection of indocyanine green (ICG) at 0.2 mg/kg guided the careful dissection of the splenic hilum and checked the spleen perfusion once the upper arterial branch was clamped. The subsequent wash-out of the ICG allowed inspection of the peripheral vascular return of the splenic remnant through polar veins. Surgery was uneventful with minimal blood loss. Follow-up ultrasound scan revealed a well-perfused small splenic remnant with no signs of recurrence. Laparoscopic partial splenectomy is feasible in benign splenic tumors, especially in those cases of peripheral location. Fluorescence facilitates the safe dissection of the splenic hilum, the visualization of the transection plane of the spleen and the perfusion of the remnant in cases of anatomically and technically complicated partial splenectomies.
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影响因子：
0.6
作者：
Fernandez-Bautista, Beatriz;Pelaez Mata, David;Carlos De Agustin, Juan
通讯作者：
Carlos De Agustin, Juan
影响因子：
1.5
作者：
Reinhart, Michaela B.;Huntington, Ciara R.;Augenstein, Vedra A.
通讯作者：
Augenstein, Vedra A.
影响因子：
2.4
作者：
Yamamichi, Taku;Oue, Takaharu;Usui, Noriaki
通讯作者：
Usui, Noriaki
影响因子：
1.8
作者：
Calisti, A;Perrotta, ML;Miele, V
通讯作者：
Miele, V
影响因子：
1.8
作者：
Kitagawa, Norihiko;Shinkai, Masato;Ohtsubo, Seiji
通讯作者：
Ohtsubo, Seiji