Esplenectomía laparoscópica en esplenomegalia masiva. A propósito de un caso / Laparoscopics plenectomy in massives plenomegaly. About a case / Esplenectomia laparoscópica na esplenomegalia maciça. Sobre um caso

RESUMEN

RESUMEN Introducción: el bazo constituye el órgano reticuloendotelial mayor del cuerpo. Este puede ser afectado por una serie de desórdenes primarios y secundarios indicativos de esplenectomía. Las primeras esplenectomías por técnicas de mínimo acceso fueron reportadas entre los años 1991 y 1992, encontrando entre sus ventajas una más pronta recuperación, mejores resultados estéticos, y menor sangrado intraoperatorio. Presentación del caso paciente de 43 años de edad que es intervenida por esplenomegalia masiva secundaria a púrpura trombocitopénica inmunológica, realizándosele esplenectomía laparoscópica satisfactoria. Discusión: las esplenomegalias masivas son aquellas cuando el bazo supera los 20 cm de longitud entre sus polos superior e inferior, siendo este criterio contraindicación relativa para esplenectomía laparoscópica. Conclusiones: la extirpación exitosa del bazo por cirugía laparoscópica en aquellos pacientes con esplenomegalia masiva puede ser factible siempre que se cumplan una serie de condiciones elementales.

ABSTRACT

ABSTRACT Introduction: the spleen is the largest reticuloendothelial organ in the body. This can be affected by a series of primary and secondary disorders indicative of splenectomy. The first splenectomies using minimal access techniques were reported between 1991 and 1992, finding among their advantages a faster recovery, better aesthetic results, and less intraoperative bleeding. Case presentation 43-year-old patient who underwent surgery for massive splenomegaly secondary to immunological thrombocytopenic purpura, undergoing satisfactory laparoscopic splenectomy. Discussion: massive splenomegalies are those when the spleen exceeds 20 cm in length between its upper and lower poles, this criterion being a relative contraindication for laparoscopic splenectomy. Conclusions: the successful removal of the spleen by laparoscopic surgery in those patients with massive splenomegaly may be feasible provided that a series of elementary conditions are met.

RESUMO

RESUMO Introduction: the spleen is the largest reticuloendothelial organ in the body. This can be affected by a series of primary and secondary disorders indicative of splenectomy. The first splenectomies using minimal access techniques were reported between 1991 and 1992, finding among their advantages a faster recovery, better aesthetic results, and less intraoperative bleeding. Case presentation 43-year-old patient who underwent surgery for massive splenomegaly secondary to immunological thrombocytopenic purpura, undergoing satisfactory laparoscopic splenectomy. Discussion: massive splenomegalies are those when the spleen exceeds 20 cm in length between its upper and lower poles, this criterion being a relative contraindication for laparoscopic splenectomy. Conclusions: the successful removal of the spleen by laparoscopic surgery in those patients with massive splenomegaly may be feasible provided that a series of elementary conditions are met.