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Fleming MA, Head WT, Aldrink JH, Michalsky MP, Diefenbach KA. Robotic-assisted splenectomy in pediatric patients. Semin Pediatr Surg 2023; 32:151260. [PMID: 36716571 DOI: 10.1016/j.sempedsurg.2023.151260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Mark A Fleming
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.
| | - W Taylor Head
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jennifer H Aldrink
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Marc P Michalsky
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Karen A Diefenbach
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
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Dragomir MP, Tudor S, Lacatus M, Stanciulea O, Trandafir B, Diaconu A, Coriu D, Colita A, Droc G, Purnichescu-Purtan R, Calin G, Vasilescu C. TNF-alpha releasing capacity of the whole blood drops after open total splenectomy, but increases after partial/subtotal or minimally invasive splenectomy. Acta Chir Belg 2021; 122:346-356. [PMID: 33886417 DOI: 10.1080/00015458.2021.1916282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The mechanisms that induce immunodeficiency after splenectomy remain unknown. The aim of this study was to measure the cytokine releasing capacity of the whole blood as an expression of the innate immunity after total (TS) and subtotal/partial splenectomy (S/PS) in order to assess the impact of splenectomy on the individual cytokine reactivity. METHODS We prospectively collected blood before (D0) and at multiple time points after splenectomy (7 days - D7, 30 days - D30, 90 days - D90, 180 days - D180, and 360 days - D360) and measured the cytokines releasing capacity of IL-6, TNF-alpha and IL-10 from whole blood under LPS stimulation which we normalized to the monocytes number. RESULTS When analyzing all splenectomies at D0, D7 and D30, normalized ΔTNF-alpha significantly dropped after splenectomy (p = .0038) and normalized ΔIL-6 and ΔIL-10 did not significantly change. More specifically, normalized ΔTNF-alpha dropped after TS (p = .0568) and significantly increased after S/PS (p = .0388). Open surgery induced a decrease in normalized ΔTNF-alpha (p = .0970), whereas minimally invasive (MI) surgery significantly increased the normalized ΔTNF-alpha releasing capacity (p = .0178). The cytokine levels were heterogenous between pathologies at D0, and ΔIL-6 dropped mainly in cirrhotic patients after splenectomy (all underwent TS), ΔTNF-alpha dropped in immune thrombocytopenic purpura patients (all underwent TS), but increased in spherocytosis (91% underwent S/PS) after splenectomy. CONCLUSIONS Splenectomy induces a decrease of the pro-inflammatory cytokine TNF-alpha and if splenic parenchyma is spared and the surgery is performed MI, this change is hindered.
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Affiliation(s)
- Mihnea P. Dragomir
- Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Stefan Tudor
- Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania
- Faculty of Medicine, Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Monica Lacatus
- Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania
- Faculty of Medicine, Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Oana Stanciulea
- Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania
| | - Bogdan Trandafir
- Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania
| | - Adriana Diaconu
- Department of Pediatric Bone Marrow Transplantation, Fundeni Hospital, Bucharest, Romania
| | - Daniel Coriu
- Faculty of Medicine, Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
| | - Anca Colita
- Faculty of Medicine, Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Department of Pediatric Bone Marrow Transplantation, Fundeni Hospital, Bucharest, Romania
| | - Gabriela Droc
- Faculty of Medicine, Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Intensive Care Department, Fundeni Clinical Instutute, Bucharest, Romania
| | - Raluca Purnichescu-Purtan
- Department of Mathematical Methods and Models, Faculty of Applied Sciences, Politehnica University of Bucharest, Bucharest, Romania
| | - George Calin
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Center for RNA Interference and Non-Coding RNAs, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Catalin Vasilescu
- Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania
- Faculty of Medicine, Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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