ObjectiveTo study the clinical manifestation, radiographic characteristics, and treatments of reactive lymphoid hyperplasia(RLH) of liver. MethodsThe clinical data and treatment process of 1 patient with RLH of liver in our hospital was analyzed retrospectively, and the other 49 cases reported in English literature were reviewed. ResultsThere were 33 pieces of case reports found in PubMed database. For all 50 patients, there were 45 female(90%) and 5 male(10%) patients, and the mean age was(57.6±14.0) years(15-85 years). Only 8 patients(16%) were discovered with multiple mass, the rest of them were solitary mass(84%). Of the 50 patients, 6 patients(12%) were discovered because of bellyache, 2 patients(4%) were discovered during operation, 2 patients(4%) were discovered by pathological examination after liver transplantation, 1 patient(2%) was discovered during autopsy, 39 patients were discovered during examination or reexamination. The tumors were located in the right lobe for 25 patients(50%), in the left lobe for 15 patients(30%), in the both lobes for 4 patients(8%), and in the caudal lobe for 1 patient(2%), while 5 cases(10%) were not given in the articles. Eleven patients(22%) had the history of malignancy, 15 patients(30%) were concomitant with autoimmune disease, and 5 patients(10%) were concomitant with virus hepatitis infection. Thirty-six patients(72%) were diagnosed as malignancy preoperatively, and 43 patients(86%) underwent surgical resection. ConclusionsRLH of liver is an extremely rare and benign condition which presents a female predilection and often concomitants with autoimmune disease and history of malignancy. Considering the risk of malignant transformation, surgical resection is recommended and further researches are necessary for better understanding of this disease.
ObjectiveTo investigate the experience in the treatment of splnic malignant tumors with laparoscopy. MethodsThe clinical data of 51 patients with splnic malignant tumor who underwent splenectomy between January 2009 and July 2015 were retrospectively reviewed. Patients were divided into two groups based on the surgical method: Open splenectomy (OS group, n=18) and laparoscopic splenectomy (LS group, n=33). The preoperative, intraoperative and postoperative data of the patients were collected and analysed, the differences of each index during perioperative period (general information), intraoperative data (operative time, estimated blood loss, the size of spleen, intraoperaive transfusion) and postoprative situation (hospital stays, the first oral intake, postoperative pancreatic fistula, rehaemorrhagia, abdominal infection or pulmonary infection and the like) were compared. ResultsLS group compared with OS group, the operative time of LS group was significantly shorter than that of OS group [(103.64±16.92) min vs. (144.44±31.10) min, P=0.000〕, the amount of bleeding of LS group [M (Q25, Q75): 60 (50, 100)〕was significantly less than the OS group [M (Q25, Q75): 150 (115, 210)〕, P=0.000. The hospitalization time of LS group was significantly shorter than the OS group [(13.61±9.91) d vs. (9.03±3.09) d, P=0.017〕, and the LS group has a lower indication of the postoprative complications of fever and pulmonary infection (P=0.010 and P=0.003). Conciusions Laparoscopic splenectomy is feasible in the treatment of splenic malignant tumors, the employment of laparoscopy can shorten the operative time, has the advantages of less bleeding, the shorten hospital stays, lower indication of postoprative complications, and being worthy of further popularization and application.