ClinicalManagement of nonparasitic splenic cysts in children: A French multicenter review of 100 cases

BackgroundThe management of nonparasitic splenic cysts (NPSC) remains controversial. Surgical resection is indicated for symptomatic or complicated forms, but no guidelines are available for asymptomatic NPSC. The aims of this study were to evaluate the management of NPSC in French hospitals and to analyze the results of management.MethodsWe conducted a retrospective multicenter study from January 2004 to December 2014 in 16 university hospitals in France. Patients with a follow-up less than 6 months were excluded. Data were extracted from the medical reports.ResultsOne hundred patients were included. Median follow-up was 12.8 months. No complications were observed for NPSC smaller than 5 cm. The size of NPSC increased significantly between the ages of 10 and 12 years. Fifteen patients were under observation; 58.3% of cysts decreased in size and 41.7% remained stable. Among the 85 operated patients, no recurrence occurred in the splenectomy group, while 11 recurrences were observed in the cystectomy group (57.9%), 3 of which required redo surgery.ConclusionsObservation is a safe treatment option for asymptomatic NPSC smaller than 5 cm. Surgery is indicated for symptomatic patients, and can be proposed for asymptomatic NPSC larger than 5 cm. Laparoscopic partial splenectomy is the technique of choice. Follow-up must be continued until the end of puberty.Levels of evidence ratingLevel III.