Most patients with splenic hemangioma present no obvious symptoms, only one of the patients in the study presented with upper left abdominal pain. With advances in imaging techniques such as ultrasound, CT and MRI, more and more patients with splenic hemangioma are detected. Hemangioma, due to secondary infarction, infection, fibrosis, calcification and its serious complications such as spontaneous rupture and bleeding, is proposed to be resected by splenectomy or partial splenectomy once detected. With the deepening of knowledge on the immunological function of the spleen and overwhelming infection after a complete resection of the spleen, more and more emphasis is placed on the performance of partial splenectomy. Some scholars have presented the indications of partial splenectomy : ① under the age of 60; ②II, III grade traumatic rupture; ③ benign diseases of the spleen (splenic hemangioma, aneurysm, arteriovenous malformation). Partial splenectomy includes regular splenectomy (in which the vessels are severed on the basis of the vascular distribution before the resection of the corresponding splenic segment, lobe or half the spleen) and irregular splenectomy (in which an irregular splenic resection is performed according to the blood supply and vitality of the spleen tissues). Segmental splenectomy is considered to be performed especially on the young people when the single benign tumor is small in size and located in the upper or lower pole or limited within a certain segment or at the edge of the spleen. Therefore, the splenic function can be preserved as much as possible and the occurrence of overwhelming infection after splenectomy can be lowered. The splenic function should be better preserved for the mean age of the patients in the study is 39.4. No complications (overwhelming infection, thrombotic events and spleen necrosis) occurred during the follow up, which demonstrated the function of the spleen was well preserved.
With the advances in minimally invasive techniques such as laparoscope, laparoscopic partial splenectomy has gradually been applied in the clinical especially for the treatment of hereditary spherocytosis. The resection of other cystic or solid tumors was also occasionally reported in the literature. After the review of the literature, our hospital has gradually performed the surgical procedure for appropriate patients.Laparoscopy,with the significant advantages of less trauma, clear exposure and quick postoperative recovery in contrast to the open partial splenectomy, sets high requirements for surgeons who should have quite skilled experience in upper abdominal laparoscopic surgery and be quite familiar with the anatomy of the splenic hilar vessels. Laparoscopy, not suitable for all the spleen tumors though, is especially performed on the tumors in exogenous growth at the edge of the spleen or in the upper or lower pole of the spleen. A laparoscopic surgery is not necessary to be performed if the tumor is huge resulting in limited space and hard to be exteriorized. In addition, Intraoperative massive haemorrhage is prone to occur if there is much adhesion between the spleen and the neighboring organs with unclear boundary. So the splenic artery should be severed and temporarily occluded. If the dissection is difficult，the laparotomy should be performed without delay, the pursuit of the minimally invasive incision would result in inner large trauma such as massive haemorrhage, which should not be encouraged.