Anatomie und Physiologie bei milzerhaltenden Eingriffen

Abstract

Anatomy and Physiology in Spleen-Preserving Surgery The basis for a successful partial splenectomy is the blood supply of each splenic segment and a high frequency of upper and lower polar arteries. The compartments of the spleen are the red pulp, the white pulp, and the marginal zone. Recent functional and immunohistological studies have documented major species differences. Furthermore, the spleen only attains its typical structure at a certain age. The development of this organ and its functional relevance for pediatric surgery are largely unknown. In splenic remnants the function of the red pulp might be sufficient to prevent Howell-Jolly bodies in the blood, but the white pulp and the marginal zone are inadequate in septicemia. The spleen plays a major role in lymphocyte recirculation, but the adhesion molecules involved are largely unknown. The immune function of the spleen is also regulated by nerves that might be involved in the regeneration of autotransplanted splenic tissue. The extrapolation from the structure and function of the spleen in adults to that in young children or from animal experiments to the human situation should only be undertaken with great caution.