| Objective: To summarize and analyze the clinical experience of surgical diagnosis and treatment of splenic space occupying lesions in our hospital,and to summarize the clinical diagnosis and treatment plan of splenic space occupying lesions.Methods: According to the related literatures,we collected patient data of patients with splenic occupancy from the First Affiliated Hospital of China Medical University in the past 10 years,and we followed up the patient's survival situation,and we established the patient's database,and we compared dates with graphpad7.0 software.Results: 1.A total of 118 splenic lesions were collected,including 33 cases were splenic tumors-like,44 cases were splenic tumors,and 41 cases were splenic tumors.The tumor-like lesions included 23 cases of splenic cysts,and 4 cases of inflammatory pseudotumor,and 6 cases of other tumors,and all of them were treated by surgery.That 8cases of tumor-like lesions underwent laparoscopic splenic cyst drainage,and 2 cases underwent laparoscopic splenectomy,and 6 cases underwent partial resection of the spleen,1 cases underwent resection of open splenic cysts,and 16 cases underwent open splenectomy.Splenic benign tumors included 29 cases of splenic hemangioma,and 8cases of splenic angioma,and 7 cases of other benign tumors,and all of them were treated by surgery.There were 4 cases of partial laparoscopic splenectomy,and 11 cases of laparoscopic splenectomy,and 29 cases of open splenectomy in benign splenic lesions.Splenic malignant tumors contained 18 cases of lymphoma,and 20 cases metastases,and 2 cases angiosarcomas,and 1 cases malignant fibroblastic tumor,of which 25 cases were treated surgically and 16 cases were conservatively treated,including two patients underwent laparoscopic splenectomy and 23 patients underwent splenectomy.2.A total of 118 cases were examined by B-ultrasound,and104 cases were examined by CT,and 10 cases were examined by PET/CT.The positioning rates of B-mode ultrasound and CT were 100%(118/118)and 100%(104/104)respectively.The accuracy rates were 27.12%(32/118)and 75%(78/104)respectively,and the PET-CT qualitative accuracy rate was 70%(7/10).3.A total of 109 cases were followed up and 9 cases were lost to follow-up.Among them,there were 30 spleentumors-like followed up and 3 cases were lost to follow-up.The longest follow-up period was 14 years.One case(3.5 years)died of other diseases;and 42 cases of splenic benign tumors were followed up and 2 cases were lost.Follow-up time was 3 months to 8 years,2 cases died for other reasons(4 years and 5.5 years);and 37 cases of splenic malignancies were followed up(surgical/unsurgical = 23/14),and 4 cases were missed(including 1 cases without surgery).Follow-up time was 3 months to 8.5 years,and 8cases died within 1 year(surgical/non-surgical = 3/5),and the survival rate of splenic lymphoma was the highest in the surgical cases,the 5-year survival rate was 68.4%,which was statistically significant(P<0.05).Conclusion: 1.The incidence of primary tumors of the spleen is low,benign lesions are more common,and minimally invasive treatment is preferred for treatment of benign lesions.Malignant splenic mass mainly by splenectomy.2.Imaging examination is the main diagnostic method for splenic space occupying lesions,of which CT has a high qualitative rate of splenic lesions,and B-ultrasound and MRI have lower qualitative rate than CT.PET/CT is highly sensitive to splenic malignant tumors,however,there is a false positive rate,especially for splenic sclerosing angimatoid noular transformation.3.Splenic malignancies lack specific biological markers and have a poor prognosis,but early diagnosis and early eradication can improve prognosis. |
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