Evaluation of risk of splenosis during laparoscopic splenectomy in rat model

• Published in: World journal of surgery 2001-07, Vol.25 (7), p.882-885
• Main Authors: Espert, Joan Josep, Targarona, Eduard M., Bombuy, Ernest, Setoain, Josep, Visa, Josep, Trias, Manuel
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Muscles - surgery; Accessory Spleen; Animals; Autopsies; Biological and medical sciences; Carbon dioxide; Disease Models, Animal; Erythrocytes; Globules; Grafting; Implants; Laparoscopy; Laparoscopy - adverse effects; Laparoseopic Splenectomy; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; Necropsy; Open Splenectomy; Peritoneal Cavity - diagnostic imaging; Peritoneal Cavity - physiopathology; Pneumoperitoneum, Artificial; Postoperative Complications; Prosthesis Implantation - adverse effects; Radionuclide Imaging; Rats; Rats, Sprague-Dawley; Risk Assessment; Scintigraphy; Spleen; Spleen - diagnostic imaging; Spleen - physiopathology; Spleen - surgery; Splenectomy; Splenectomy - adverse effects; Splenic Function; Splenic Tissue; Splenosis; Splenosis - diagnostic imaging; Splenosis - etiology; Splenosis - physiopathology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tissues
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-001-0045-0

Laparoscopic splenectomy (LS) is an alternative to open surgery. However, there is a theoretic risk of splenosis and abdominal cavity dissemination of splenic cells if the splenic capsule is broken, as seen by experimental evidence of tumoral cell mobilization by the pneumoperitoneum. We evaluated the features of splenosis after splenectomy operated via an open approach or under laparoscopic control in an experimental model in the rat. A total of 65 Sprague‐Dawley rats were distributed in seven groups that included the open approach, CO2 pneumoperitoneum LS, or wall lift LS with or without a splenic graft. Splenic function was evaluated 90 day later through (1) scintigraphy with Tc‐labeled heat‐damaged erythrocytes; (2) determination of circulating “pitted” cells; and (3) analysis of the distribution of splenic pulp in the peritoneal cavity. Scintigraphy did not show viable residual tissue in any group after splenectomy; splenic activity in the splenic fossa was observed in 40% of the animals with grafts. Splenectomy increased the “pit” cell count, but it was reduced to normal values with a splenic graft. Necropsy showed normal splenic tissue in the splenic fossa in 100% of animals with a graft. Abdominal implants were observed significantly more frequently after CO2 LS than after the open surgery or a wall lift LS (80% vs. 20% vs. 30%; p