临床小儿外科杂志2025，Vol.24Issue(5)：468-472,5.DOI:10.3760/cma.j.cn101785-202406029-013
儿童脾脏占位性病变围手术期诊疗分析
Perioperative management of pediatric splenic lesions
摘要
Abstract
Objective To summarize the surgical diagnoses and treatments of space-occupying splenic lesions in children and provide references for proper clinical managements.Methods The relevant clinical da-ta were retrospectively reviewed for 36 children with space-occupying splenic lesions between January 2012 and December 2023.Baseline profiles,clinical manifestations,surgical approaches and prognoses were systematically summarized.Results Preoperative imaging confirmed space-occupying splenic lesions in all 36 children.There were 24 boys and 12 girls with a median age of 119.5(37-198)month.The surgical procedures includ-ed open surgery(n=15),laparoscopy(n=17)and conversion into open surgery(n=4).Three cases under-went indocyanine green(ICG)fluorescent imaging-guided splenic lesion resection,achieving tumor-free mar-gins and preserved splenic perfusion postoperatively.Pathological diagnoses confirmed splenic malignant lym-phoma(n=1)while the remainders(n=35)were benign,including splenic epithelial cysts(n=17),lym-phangiomas(n=7),sclerosing angiomatoid nodular transformation(SANT,n=4)and hemangiomas(n=7,comprising 4 littoral cell angiomas,2 multinodular hemangiomas and 1 solitary hemangioma).Total splenectomy(n=5)and partial splenectomy(n=31)were performed.Among 3 cases of laparoscopic cyst fenestration and drainage,2 recurrent cases remained under clinical observations.The remaining 28 cases with preserved spleens showed no recurrence,vascular thrombosis or severe post-splenectomic infection.Platelet counts spiked in both total splenectomy and partial splenectomy groups postoperatively.Conclusions Surgical intervention remains a primary treatment for splenic space-occupying lesions in children.Preoperative planning should focus upon tumor location,size and individual characteristics.Laparoscopic partial splenectomy is both safe and effective.关键词
脾脏占位性病变/外科手术/治疗结果/儿童Key words
Splenic Occupation/Surgical Procedures,Operative/Treatment Outcome/Child引用本文复制引用
沈启阳,周建峰,姜斌,李涛..儿童脾脏占位性病变围手术期诊疗分析[J].临床小儿外科杂志,2025,24(5):468-472,5.基金项目
江苏省卫健委医学科研项目(MQ2024023) Medical Research Project of Jiangsu Provincial Health Commission(MQ2024023) （MQ2024023）
