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Objective To investigate the clinical value of splenic autotransplantation in patients with severe splenic trauma. Methods A prospective case-control study were performed in 120 patients with traumatic spleen rupture including the treatment group 72 patients and the control group 48 patients. The treatment group were treated with splenectomy plus spleen autotransplantation and the control group merely under splenectomy. Compare the operation time,operative blood loss,postoperative hospital stay,postoperative complications and the immune indexes before and different period after operation. Results Autologous spleen transplantation takes more time than merely splenectomy(P<0.05),but the operative blood loss,postoperative hospital stay and postopera-tive complications were no significant difference. 1 days after operation,the immune indexes of two groups were significantly lower than those before operation(P < 0.05),and 1 week after operation the immune indexes of two groups were significantly elevated(P<0.05).The immune indexes of the treatment group were better than those of the control group 3 months after operation(P < 0.05),and there was no significant difference compared with preoperative. Conclusion Splenectomy cause the decrease in the immune function,but the immune function can quickly rise to a certain level in short term.The splenic autotransplantation can effectively restore the immune func-tion to the preoperative level.
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Objective To study the imaging findings of unexpected splenic autotransplantation after splenectomy and to improve diagnostic accuracy of splenic autotransplantation.Methods The findings of 10 patients with splenic autotransplantation confirmed by histology in our hospital were retrospectively reviewed.In 7 patients CT and plain and dynamic enhanced MRI scanning were carried out,and in 2 of them 99mTc-DRBC scanning were also done.In 3 patients,plain and dynamic enhanced CT scannings were done.Results (1) Multiple lesions were detected in 7 patients and a single lesion in 3 patients.The masses were round and oval.The nodules were in the splenic fossa in 9 patients,in the pancreatic tail in 4 patients,in the right liver in 2 patients and in other of parts of the abdominal cavity in 2 patients.These nodules varied in size and 94.6％ showed a maximum diameter of less than 3 cm; (2) The findings on CT and MR:all the nodules were homogeneous with soft tissue density.There was no cystic degeneration,necrosis and calcification.In one patient with a nodule in the pancreatic tail,there was a slightly short T1 and short T2 signals.Other nodules showed long T1 and long T2 signals.All the signals from the nodules were homogeneous and their outlines were clear.In a patient with a nodule in the right liver,the blood supply came from the abdominal aorta.There was a surrounding thin layer of low-density ring which showed long T1 and long T2 signals.The enhanced features on CT and MR were similar.The nodules showed homogeneous or inhomogeneous enhancement in the arterial phase,with continuous homogeneous enhancement in the portal venous phase,with an obvious decline in the delayed phase;(3) The findings of 18 F-FDG PET:The nodules had obvious increase in FDG uptake.Conclusions In patients with a history of splenic trauma or splenectomy,abdominal nodules with multiple,homogeneous density or signal,clear outline,enhanced features similar to spleen,splenic autotransplantation should be considered.99mTc-DRBC scanning is helpful in the diagnosis of splenic autotransplantation.
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Objective To study the clinical characteristics and to summarize our experience in the diagnosis and treatment of ectopic splenic autotransplantation (ESAP) many years after splenic rupture and splenectomy.Methods The clinical data of 15 patients with ESAP who were treated in the People's Hospital of Zhengzhou from January 1998 to January 2013 were retrospectively analyzed.Results Of the 15 patients,2 patients presented with intestinal obstruction due to the ectopic splenic tissues and required partial resection of small intestine.In 5 patients,the ectopic splenic tissues were in the greater omentum which required resection of part or the whole of the greater omentum.In 4 patients,the ectopic splenic tissues were in the mesentery which required partial or total resection of the tissues.The ectopic tissues were in the pelvis in 3 patients and resection of the left fallopian tube was carried out in 2 patients and resection of the pelvic tissues in 1 patient.In 1 patient the diagnosis was made under laparoscopic biopsy,thus avoiding open surgery.Three patients had multiple implanted sites for these ectopic splenic tissues.Conclusions ESAP is an uncommon disease and it has no clinical characteristics.It is easy to confuse the condition with metastatic deposits.A diagnosis could be made only by combining the history with magnetic resonance imaging,or 99mTc study of red blood cells,or laparoscopic exploration and biopsy.
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Objective. Compare the fagocitary function and the splenic regeneration of senile rats submitted to subtotal splenectomy or total splenectomy followed by splenic autotransplantation. Methods. Thirty Wistar rats have been ramdomly distributed into two groups with fifiteen animals each. One group named subtotal splenectomy (SS) have been submitted to a subtotal splenectomy surgery and the other group, autoimplant (AT) have been submitted to total splenectomy followed by autotransplantation. The animals from SS group have been redistributed again into three subgroups (n = 5) SS-1, SS-2 and SS-3 and submitted to reoperation and euthanasia on the 15th, 30th and 60th days respectively. In reoperation, the remaining spleen from SE group and the autotransplantation fragments from the AT animals group have been removed and histologically analised observing and classifying the degree of spleen regeneration into absent (0), discrete (1), moderate (2) and intense (3) and also counting the carbon colloidal marked macrophages. Results. All the rats submited to subtotal splenectomy was sacrificed with 15, 30, and 60 days and presented na intense splenic regeneration. In another group 80 % of the rats does not presented a splenic regeneration, but with 30 and 60 days, 60% of the rats had a moderate regeneration. Regeneration level considered as important and 300 or more macrophages were found in samples of all animals from subgroups SS-1, SS-2 and SS-3. In samples of animalsfrom subgroups AT-1, AT-2 and AT-3, regeneration level from absent to moderate and less than 200 macrophages were found. Conclusion. Under the conditions that this study was performed, the splenic regeneration and the fagocitary function of senile rats after subtotal splenectomy were more evident than those of autotransplantation.
Objetivo. Comparar a função fagocitária e a regeneração esplênica de ratos senis submetidos a esplenectomia subtotal ou a esplenectomia total seguida de autoimplante esplênico. Métodos. Trinta ratos Wistar foram separados aleatoriamente em dois grupos com quinze animais em cada, a saber: grupo esplenectomia subtotal (SS) que foram submetidos a esplenectomia subtotal e o grupo do autoimplante (AT) que foram submetidos a esplenectomia total seguida de autoimplante. Os animais do grupo SS foram redistribuídos aleatoriamente em três subgrupos (n = 5) SS-1, SS-2 e SS-3 e submetidos a reoperação e eutanásia após 15, 30 e 60 dias respectivamente. Três horas antes da reoperação, todos os animais receberam uma única dose intravenosa de carbono coloidal. Os animais do grupo AT também foram redistribuídos aleatoriamente em três subgrupos com cinco animais cada, AT-1, AT-2 e AT-3 e submetidos a reoperação e eutanásia após 15, 30 e 60 dias respectivamente. Na reoperação, o baço remanescente do grupo SS e os fragmentos autoimplantandos nos animais do grupo AT foram removidos e analisados histologicamente quanto ao grau de regeneração esplênica classificada em ausente (0), discreta (1), moderada (2) intensa (3) e contagem dos macrófagos marcados com carbono coloidal. Resultados. Todos os ratos submetidos à esplenectomia subtotal sacrificados com 15, 30 e 60 dias tiveram regeneração intensa do baço. No grupo submetido à esplenectomia e autoimplante, quinze dias após o procedimento, 80% dos ratos não apresentaram regeneração do baço. Porém, com trinta dias, 60% apresentaram regeneração moderada. O mesmo resultado foi observado após sessenta dias. O nível de regeneração foi considerado importante e 300 ou mais macrófagos foram encontrados em todos os animais dos grupos SS-1, SS-2 e SS-3. No grupo correspondente a AT-1, AT-2 e AT-3, o nível de regeneração encontrado foi ausente ou moderado e sempre menos de 200 macrófagos por campo foram identificados. Conclusão. Nas condições...