<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0026-1742</journal-id>
<journal-title><![CDATA[Revista de la Facultad de Medicina (México)]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Fac. Med. (Méx.)]]></abbrev-journal-title>
<issn>0026-1742</issn>
<publisher>
<publisher-name><![CDATA[Universidad Nacional Autónoma de México, Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0026-17422018000600020</article-id>
<article-id pub-id-type="doi">10.22201.fm.24484865e.2018.61.6.03</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Esplenectomía laparoscópica como tratamiento para la púrpura trombocitopénica idiopática y la esplenomegalia masiva en un hospital de segundo nivel]]></article-title>
<article-title xml:lang="en"><![CDATA[Laparoscopic splenectomy as a treatment for idiopathic thrombocytopenic purpura and massive splenomegaly in a second-level hospital]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kim-Koh]]></surname>
<given-names><![CDATA[Min Jeong]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Souza-Gallardo]]></surname>
<given-names><![CDATA[Luis Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Centro Médico Nacional Siglo XXI &#8220;Dr. Bernardo Sepúlveda&#8221; ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital General de Zona #32 &#8220;Dr. Mario Madrazo Navarro&#8221; ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>61</volume>
<numero>6</numero>
<fpage>20</fpage>
<lpage>25</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0026-17422018000600020&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0026-17422018000600020&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0026-17422018000600020&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: Actualmente, la esplenectomía es una opción terapéutica para diversas patologías hematológicas, especialmente las refractarias a tratamiento médico. Debido a las ventajas del uso de la cirugía de mínima invasión, como son un menor dolor postoperatorio, recuperación rápida, menor sangrado y mejores resultados estéticos, la laparoscopía se ha convertido en el abordaje estándar en pacientes sometidos a esplenectomía.  Caso clínico: Varón de 34 años con diagnóstico de púrpura trombocitopénica idiopática (PTI). Recibió tratamiento con esteroide y danazol pero persistió trombocitopenia. Enviado a consulta de cirugía general por falla en el tratamiento médico. Se realizó esplenectomía laparoscópica sin complicaciones, extrayendo pieza quirúrgica con medidas de 25 × 16 cm con un peso de 1,235 gramos. Tiempo quirúrgico de 115 minutos, sangrado transoperatorio de 800 cm3.  Conclusión: El tratamiento de la PTI refractaria a tratamiento médico es la esplenectomía laparoscópica, la cual es una opción viable y segura con tasas bajas de complicaciones, no importando el tamaño del órgano.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Nowadays, a splenectomy is a therapeutic option for hematologic diseases, especially those that do not respond to medical treatment. It is a minimally invasive surgery and has advantages such as less postoperative pain, rapid recovery, less blood loss and better cosmetic results. Laparoscopy has become the standard approach for patients undergoing a splenectomy.  Case report: We present the case of a 34-year old male patient with idiopatic thrombocytopenic purpura. He was treated with steroid and danazol with a persistent thrombocytopenia. Due to the failure of the treatment, a laparoscopic splenectomy was performed without any complication. The extracted spleen measured 25 × 16 cm weighing 1.235 g. The surgical time was of 115 min and the transoperative loss of blood was of 800 cc.  Conclusion: The laparoscopic splenectomy is a safe and viable therapeutic option. Various studies have shown low conversion rates, less morbidity and a shorter hospital stay. Laparoscopic splenectomy is an effective therapy regardless of the size of the spleen.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Esplenectomía]]></kwd>
<kwd lng="es"><![CDATA[laparoscopía]]></kwd>
<kwd lng="es"><![CDATA[esplenomegalia]]></kwd>
<kwd lng="es"><![CDATA[púrpura]]></kwd>
<kwd lng="en"><![CDATA[Splenectomy]]></kwd>
<kwd lng="en"><![CDATA[laparoscopy]]></kwd>
<kwd lng="en"><![CDATA[splenomegaly]]></kwd>
<kwd lng="en"><![CDATA[purple]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cheng]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Tao]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Yu]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic splenectomy is a better surgical approach for spleen-relevant disorders: a comprehensive meta-analysis based on 15-year literatures]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2016</year>
<volume>30</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>4575-88</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Habermalz]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Sauerland]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Decker]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Delaitre]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Gigot]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Leandros]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES).]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2008</year>
<volume>22</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>821-48</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Delaitre]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Maignien]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Icard]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic splenectomy]]></article-title>
<source><![CDATA[Br J Surg]]></source>
<year>1992</year>
<volume>79</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1334</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Koshenkov]]></surname>
<given-names><![CDATA[VP]]></given-names>
</name>
<name>
<surname><![CDATA[Németh]]></surname>
<given-names><![CDATA[ZH]]></given-names>
</name>
<name>
<surname><![CDATA[Carter]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic splenectomy: outcome and efficacy for massive and supramassive spleens]]></article-title>
<source><![CDATA[Am J Surg]]></source>
<year>2012</year>
<volume>203</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>517-22</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Corcione]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Pirozzi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Aragiusto]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Galante]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Sciuto]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic splenectomy: experience of a single center in a series of 300 cases]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2012</year>
<volume>26</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>2870-6</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Targarona]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
<name>
<surname><![CDATA[Balagué]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Berindoague]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Martinez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hernandez]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Trias]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic splenectomy in massive splenomegaly]]></article-title>
<source><![CDATA[Eur Surg]]></source>
<year>2006</year>
<volume>38</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>176-82</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Feldman]]></surname>
<given-names><![CDATA[LS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic Splenectomy: Standardized Approach]]></article-title>
<source><![CDATA[World J Surg]]></source>
<year>2011</year>
<volume>35</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>1487-95</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fisichella]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[YM]]></given-names>
</name>
<name>
<surname><![CDATA[Pappas]]></surname>
<given-names><![CDATA[SG]]></given-names>
</name>
<name>
<surname><![CDATA[Abood]]></surname>
<given-names><![CDATA[GJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic Splenectomy: Perioperative Management, Surgical Technique, and Results]]></article-title>
<source><![CDATA[J Gastrointest Surg]]></source>
<year>2014</year>
<volume>18</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>404-10</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moris]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Dimitriou]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Griniatsos]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic Splenectomy for Benign Hematologic Disorders in Adults: A Systematic Review]]></article-title>
<source><![CDATA[In vivo]]></source>
<year>2017</year>
<volume>31</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>291-302</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhou]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Cai]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Peng]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Feasibility and Safety of Laparoscopic Splenectomy for Massive Splenomegaly: A Comparative Study]]></article-title>
<source><![CDATA[J Surg Res]]></source>
<year>2001</year>
<volume>171</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>e55-60</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Zhou]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Pankaj]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparative treatment and literature review for laparoscopic splenectomy alone versus preoperative splenic artery embolization splenectomy]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2012</year>
<volume>26</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>2758-66</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nitta]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Fujii]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Kawasaki]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Takasaka]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Kawata]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Onaka]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Efficacy and surgical procedures of preoperative splenic artery embolization for laparoscopic splenectomy of massive splenomegaly: A case report]]></article-title>
<source><![CDATA[Int J Surg Case Rep]]></source>
<year>2015</year>
<volume>16</volume>
<page-range>174-6</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hellman]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Arvidsson]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Rastad]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Handport-assisted laparoscopic splenectomy in massive splenomegaly]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2000</year>
<volume>14</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1177-9</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bargellini]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Martellucci]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bruscino]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Prosperi]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Valeri]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic Splenectomy 15 Years After]]></article-title>
<source><![CDATA[Surg Laparosc Endosc Percutan Tech]]></source>
<year>2014</year>
<volume>24</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>47-9</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mathioulaki]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tzardis]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Laopodis]]></surname>
<given-names><![CDATA[V.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic Splenectomy - (Pros and Cons).]]></article-title>
<source><![CDATA[Hellenic J Surg.]]></source>
<year>2012</year>
<volume>84</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>172-81</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Al-Mulhim]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic splenectomy for massive splenomegaly in benign hematological diseases]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2012</year>
<volume>26</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>3186-9</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marte]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Scuderi]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Rocca]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Surfaro]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Migliaccio]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ceriello]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic splenectomy: a single center experience. Unusual cases and expanded inclusion criteria for laparoscopic approach.]]></article-title>
<source><![CDATA[Updates Surg]]></source>
<year>2013</year>
<volume>65</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>115-9</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
