Management of nonparasitic splenic cysts in children: A French multicenter review of 100 cases.

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.

journal_name

J Pediatr Surg

authors

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

doi

10.1016/j.jpedsurg.2017.01.054

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

1465-1470

issue

9

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(17)30087-8

journal_volume

52

pub_type

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