Brief Article
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World J Gastroenterol. Jun 28, 2013; 19(24): 3854-3860
Published online Jun 28, 2013. doi: 10.3748/wjg.v19.i24.3854
Laparoscopic splenectomy for treatment of splenic marginal zone lymphoma
Zhong Wu, Jin Zhou, Xin Wang, Yong-Bin Li, Ting Niu, Bing Peng
Zhong Wu, Xin Wang, Yong-Bin Li, Bing Peng, Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jin Zhou, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Ting Niu, Department of Hematology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Wu Z and Zhou J contributed equally to this work; Wu Z and Zhou J made substantial contributions to the conception and design of the study, data acquisition, and data analysis and interpretation; Wu Z, Wang X and Li YB drafted the article and revised it critically for important intellectual content; Peng B and Niu T provided final approval of the version to be published.
Correspondence to: Bing Peng, MD, Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, Sichuan Province, China. pengbing84@hotmail.com
Telephone: +86-28-85422474 Fax: +86-28-85422474
Received: January 10, 2013
Revised: April 28, 2013
Accepted: May 17, 2013
Published online: June 28, 2013
Processing time: 169 Days and 4.6 Hours
Abstract

AIM: To investigate the short-term and long-term efficacy and safety of laparoscopic splenectomy (LS) for treatment of splenic marginal zone lymphoma (SMZL).

METHODS: A total of 18 continuous patients who were diagnosed with SMZL and underwent LS in our department from 2008 to 2012 were reviewed. The perioperative variables and long-term follow-up were evaluated. To evaluate the efficacy and safety of this procedure better, we also included 34 patients with liver cirrhosis who underwent LS, 49 patients with immune thrombocytopenia (ITP) who underwent LS, and 20 patients with SMZL who underwent open splenectomy (OS). The results observed in the different groups were compared.

RESULTS: No differences were found in the sex and Child-Pugh class of the patients in SMZL-LS, SMZL-OS, ITP, and liver cirrhosis groups. The splenic length of the patients in the SMZL-LS group was similar to that in the SMZL-OS and liver cirrhosis groups but significantly longer than in the ITP group. The SMZL-LS group had a significantly longer operating time compared with the SMZL-OS, ITP, and liver cirrhosis groups, and the SMZL-LS group exhibited significantly less blood loss compared with the SMZL-OS group. No difference was found in the length of the postoperative hospital stay between the SMZL-LS, SMZL-OS, ITP, and liver cirrhosis-LS groups. After surgery, 6 (33.3%) SMZL-LS patients suffered slight complications. During mean follow-up periods of 13.6 and 12.8 mo, one patient from the SMZL-LS group and two from the SMZL-OS group died as a result of metastasis after surgery. None of the ITP and liver cirrhosis patients died.

CONCLUSION: LS should be considered a feasible and safe procedure for treatment of SMZL in an effort to improve the treatment options and survival of patients.

Keywords: Splenic marginal zone lymphoma; Laparoscopic splenectomy; Open splenectomy; Liver cirrhosis; Immune thrombocytopenia

Core tip: Laparoscopic splenectomy (LS) achieves excellent results for treatment of benign hematological diseases. The role of LS in treatment of splenic marginal zone lymphoma (SMZL) is difficult to define due to the associated splenomegaly, which may influence long-term outcomes. We investigated the perioperative variables and long-term follow-up of 18 SMZL patients who underwent LS and compared them with SMZL patients who underwent open splenectomy, immune thrombocytopenia patients who underwent LS, and liver cirrhosis patients who underwent LS. LS should be considered an appropriate treatment strategy for SMZL patients in an effort to improve the treatment options and survival of these patients.