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The purpose of this study is compare two different surgical treatments of splenic artery aneurysms: open and laparoscopic approach.
Laparoscopy has not spread into vascular surgery as it has in other surgical branches and still remains in the hands of a minority of surgeons. Splenic artery aneurysm (SAA) is an exception to the rule: an easy-to-reach position and relatively safe control favour the progressive diffusion of laparoscopic techniques.
An increasing number of cases is managed by minimally invasive surgery originating a number of case reports and small series published in recent literature. These papers are unanimous in signalling the feasibility, safety and effectiveness of laparoscopic technique as well as its appreciation by patients -often young females- who harbour the disease. However, perplexities still remain concerning the real potential of laparoscopy in this specific field, in particular considering the spectrum of technical solutions to be performed, the splenectomy rate and the feasibility and results of reconstructive surgery.
The low incidence of the disease justifies the low number of published laparoscopic series enrolling an adequate number of patients and, in particular, the absence of papers comparing open and laparoscopic techniques.
This study reports the first prospective randomized comparison of the different surgical techniques.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Laparoscopy | Active Comparator | Includes all patient underwent intervention with a laparoscopic approach, even if converted to open surgery during intervention |
|
| Open surgery | Active Comparator | Includes all the patients underwent intervention with a laparotomic approach; it does not include patient underwent laparoscopic approach and then converted in laparotomy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laparoscopic splenic aneurysm repair, eventual splenectomy | Procedure | Aneurysmectomy and eventual artery reconstruction or splenectomy performed with a laparoscopic approach |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall postoperative morbidity rate | According to Dindo-Clavien classification of postoperative complication, we collect in a prospective way and classify all the possible complication by direct clinical evaluation and additional blood sample, imaging or endoscopy if required. | During and after hospital stay, an expected average of 50 months |
| Measure | Description | Time Frame |
|---|---|---|
| Resumption of oral diet | Time between the intervention and patient oral intake without problems | Partcipants will be followed for the duration of hospital stay, an expected average of one week |
| Intra-abdominal surgical drain removal time |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Guido AM Tiberio, MD | Università degli Studi di Brescia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Azienda Ospedaliera Spedali Civili di Brescia | Brescia | BS | 25123 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19390269 | Background | Ha JF, Sieunarine K. Laparoscopic splenic artery aneurysm resection: review of current trends in management. Surg Laparosc Endosc Percutan Tech. 2009 Apr;19(2):e67-70. doi: 10.1097/SLE.0b013e31819bd4e7. | |
| 10394168 | Background | Arca MJ, Gagner M, Heniford BT, Sullivan TM, Beven EG. Splenic artery aneurysms: methods of laparoscopic repair. J Vasc Surg. 1999 Jul;30(1):184-8. doi: 10.1016/s0741-5214(99)70190-4. |
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| Laparotomic splenic artery aneurysm repair, eventual artery reconstruction or splenectomy | Procedure | Aneurysmectomy and eventual artery reconstruction or splenectomy performed with a laparotomic approach |
|
Time between intervention and removal of surgical drain
| Partcipants will be followed for the duration of hospital stay, an expected average of one week |
| Hospital stay length | Time between intervention and discharge | Partcipants will be followed for the duration of hospital stay, an expected average of one week |
| 19631859 | Background | Pietrabissa A, Ferrari M, Berchiolli R, Morelli L, Pugliese L, Ferrari V, Mosca F. Laparoscopic treatment of splenic artery aneurysms. J Vasc Surg. 2009 Aug;50(2):275-9. doi: 10.1016/j.jvs.2009.03.015. |
| 12397723 | Background | Suzuki H, Shimura T, Asao T, Nomoto K, Kanoh K, Tuboi K, Wada S, Kuwano H. Laparoscopic resection of splenic artery aneurysm; a case report. Hepatogastroenterology. 2002 Nov-Dec;49(48):1520-2. |
| 19692887 | Background | Obuchi T, Sasaki A, Nakajima J, Nitta H, Otsuka K, Wakabayashi G. Laparoscopic surgery for splenic artery aneurysm. Surg Laparosc Endosc Percutan Tech. 2009 Aug;19(4):338-40. doi: 10.1097/SLE.0b013e3181a89206. |
| 15959711 | Background | Reardon PR, Otah E, Craig ES, Matthews BD, Reardon MJ. Laparoscopic resection of splenic artery aneurysms. Surg Endosc. 2005 Apr;19(4):488-93. doi: 10.1007/s00464-004-8916-8. Epub 2005 Feb 3. |
| 11444759 | Background | de Csepel J, Quinn T, Gagner M. Laparoscopic exclusion of a splenic artery aneurysm using a lateral approach permits preservation of the spleen. Surg Laparosc Endosc Percutan Tech. 2001 Jun;11(3):221-4. |
| 16773011 | Background | Sandford RM, Lloyd DM, Ross Naylor A. Laparoscopic ligation of splenic artery aneurysm. Surg Laparosc Endosc Percutan Tech. 2006 Apr;16(2):102-3. doi: 10.1097/00129689-200604000-00010. |
| 10854524 | Background | Adham M, Blanc P, Douek P, Henri L, Ducerf C, Baulieux J. Laparoscopic resection of a proximal splenic artery aneurysm. Surg Endosc. 2000 Apr;14(4):372. doi: 10.1007/s004640010051. |
| 11984676 | Background | Meinke AK, Floch NR, Dicorato MP. Laparoscopic options in the treatment of splenic artery aneurysms. Surg Endosc. 2002 Jul;16(7):1107. doi: 10.1007/s00464-002-0003-4. Epub 2002 May 3. |
| 15944609 | Background | Mastracci TM, Cadeddu M, Colopinto RF, Cina C. A minimally invasive approach to the treatment of aberrant splenic artery aneurysms: a report of two cases. J Vasc Surg. 2005 Jun;41(6):1053-7. doi: 10.1016/j.jvs.2005.01.056. |
| 1525102 | Background | Holdsworth RJ, Gunn A. Ruptured splenic artery aneurysm in pregnancy. A review. Br J Obstet Gynaecol. 1992 Jul;99(7):595-7. doi: 10.1111/j.1471-0528.1992.tb13828.x. No abstract available. |
| 19596508 | Background | Ha JF, Phillips M, Faulkner K. Splenic artery aneurysm rupture in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2009 Oct;146(2):133-7. doi: 10.1016/j.ejogrb.2009.05.034. Epub 2009 Jul 10. |
| 12089631 | Background | Abbas MA, Stone WM, Fowl RJ, Gloviczki P, Oldenburg WA, Pairolero PC, Hallett JW, Bower TC, Panneton JM, Cherry KJ. Splenic artery aneurysms: two decades experience at Mayo clinic. Ann Vasc Surg. 2002 Jul;16(4):442-9. doi: 10.1007/s10016-001-0207-4. Epub 2002 Jul 1. |
| 11336361 | Background | Jung SI, Joh YG, Um JW, Suh SO, Whang CW, Corbascio M. The Seoul experience of splenic artery aneurysms. Ann Chir Gynaecol. 2001;90(1):10-4. |
| 11754862 | Background | Pulli R, Innocenti AA, Barbanti E, Dorigo W, Turini F, Gatti M, Pratesi C. Early and long-term results of surgical treatment of splenic artery aneurysms. Am J Surg. 2001 Nov;182(5):520-3. doi: 10.1016/s0002-9610(01)00744-9. |
| 17243878 | Background | Kokkalera U, Bhende S, Ghellai A. Laparoscopic management of splenic artery aneurysms. J Laparoendosc Adv Surg Tech A. 2006 Dec;16(6):604-8. doi: 10.1089/lap.2006.16.604. |
| 20569943 | Background | Al-Habbal Y, Christophi C, Muralidharan V. Aneurysms of the splenic artery - a review. Surgeon. 2010 Aug;8(4):223-31. doi: 10.1016/j.surge.2009.11.011. Epub 2010 Mar 12. |
| 14627251 | Background | Heestand G, Sher L, Lightfoote J, Palmer S, Mateo R, Singh G, Moser J, Selby R, Genyk Y, Jabbour N. Characteristics and management of splenic artery aneurysm in liver transplant candidates and recipients. Am Surg. 2003 Nov;69(11):933-40. |
| 7771620 | Background | Mattar SG, Lumsden AB. The management of splenic artery aneurysms: experience with 23 cases. Am J Surg. 1995 Jun;169(6):580-4. doi: 10.1016/s0002-9610(99)80225-6. |
| 19877249 | Background | Moon DB, Lee SG, Hwang S, Kim KH, Ahn CS, Ha TY, Song GW, Jung DH, Ko GY, Sung KB. Characteristics and management of splenic artery aneurysms in adult living donor liver transplant recipients. Liver Transpl. 2009 Nov;15(11):1535-41. doi: 10.1002/lt.21885. |
| 21276711 | Background | Giulianotti PC, Buchs NC, Coratti A, Sbrana F, Lombardi A, Felicioni L, Bianco FM, Addeo P. Robot-assisted treatment of splenic artery aneurysms. Ann Vasc Surg. 2011 Apr;25(3):377-83. doi: 10.1016/j.avsg.2010.09.014. Epub 2011 Jan 28. |
| 19037534 | Background | Lee SY, Florica O. Laparoscopic resection of splenic artery aneurysm with preservation of splenic function. Singapore Med J. 2008 Nov;49(11):e303-4. |
| ID | Term |
|---|---|
| D000783 | Aneurysm |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D013156 | Splenectomy |
| ID | Term |
|---|---|
| D013514 | Surgical Procedures, Operative |
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