The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Blood clearance of Howell–Jolly bodies in an experimental autogenic splenic implant model. BJS 2014; 101: 820-827.

Published: 23rd April 2014

Authors: R. G. Marques, S. B. S. G. Lucena, C. E. R. Caetano, V. Oliveira de Sousa, M. C. Portela, A. Petroianu et al.

Background

Autogenic splenic implant (ASI) is one of the few alternatives for preservation of splenic tissue when total splenectomy is inevitable. The aim of this study was to determine the morphological and functional regeneration of ASIs, as indicated by the clearance of Howell–Jolly (HJ) bodies, in an experimental model.

Method

Ninety‐nine male Wistar rats were divided into three groups: sham‐operated (group 1), total splenectomy alone (group 2), and total splenectomy combined with ASI (group 3). Animals in group 3 were further allocated to nine subgroups of nine rats each, and analysed at different time points (1, 4, 8, 12, 16, 20, 24, 28 and 32 weeks after surgery). Blood smears were prepared at predetermined times for detection of HJ bodies. Morphological regeneration of tissue in the ASI was analysed by histology.

Results

At 1 week, the regenerated mass corresponded to about 7 per cent of the tissue implanted, reaching approximately 54 per cent at 24 weeks. The HJ body levels were increased in groups 2 and 3 until 8 weeks after surgery, following which levels in the ASI group became similar to those in the sham‐operated group. HJ bodies were difficult to detect when a level of 22·5 per cent of regenerated ASI mass was reached.

Conclusion

Functional regeneration of ASIs occurred from 8 weeks after surgery. When 22·5 per cent of regenerated ASI mass was reached almost no HJ bodies could be observed in the bloodstream, resembling a spleen in situ.

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