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      Lipídios plasmáticos após esplenectomia total e parcial em cães Translated title: The plasma lipids after total and partial splenectomy in dogs

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          Abstract

          OBJETIVO: Avaliar o efeito da esplenectomia total e parcial (hemiesplenectomia e esplenectomia subtotal) no lipidograma de cães. MÉTODO: Foram operados 38 animais, adultos, machos, mestiços, com peso entre 13kg e 15kg. No pré-operatório, depois do exame clínico e jejum de 12 horas de uma dieta-padrão, foram realizados hemograma e lipidograma. Após anestesia geral com tiopental sódico os cães foram submetidos à laparotomia mediana supra e infra-umbilical. Procedeu-se no grupo 1, de sete cães, apenas à manipulação do baço (simulado); no grupo 2, de nove cães, à hemiesplenectomia cranial; no grupo 3, de nove cães, à esplenectomia subtotal, com preservação do pólo inferior do baço, após ligadura e secção dos troncos principais dos vasos esplênicos próximos ao hilo; e no grupo 4, de 13 cães, à esplenectomia total. RESULTADOS: No grupo 4 (esplenectomia total), quando comparamos os valores do lipidograma dos diferentes períodos pós-operatórios com os do pré-operatório, os nossos resultados mostraram que houve aumento significante do colesterol total em todos os períodos pós-operatórios (p < 0,05, p < 0,01). O HDL aumentou significantemente no 7º (p < 0,01) e 28º dias de pós-operatório (PO) (p < 0,05), e não significantemente (p>0,05) no 56º PO. O LDL aumentou significantemente no 56º PO (p < 0,01) em relação também aos demais períodos do pós-operatório. Os triglicerídeos e VLDL não apresentaram alterações significantes. Nos animais dos grupos 1 e 3 não houve alterações significantes. Nos do grupo 2, houve aumento significante do colesterol no 7º PO. Não houve diferença estatisticamente significante de peso entre os remanescentes das esplenectomias parciais. CONCLUSÕES: A análise dos resultados nos permitiu concluir que a esplenectomia total induz aumento significante do colesterol total, das frações HDL e LDL, enquanto os níveis de triglicerídios e a fração VLDL não sofrem alterações; a conservação da metade inferior do baço ou a esplenectomia subtotal, com preservação do pólo inferior, protege o animal de alterações lipídicas significantes.

          Translated abstract

          BACKGROUND: The purpose of this study was to evaluate the effect of partial (hemi-splenectomy and subtotal splenectomy) and total splenectomy in the dogs lipidic profile. METHOD: Thirty eight (38) mongrel male dogs, with weight varying between 13 Kg and 15 Kg were operated. After clinical evaluation and twelve hour fasting of standard diet, preoperatively hemogram and lipidic profile were evaluated. After general anaesthesia with sodium thiopental, the dogs were submitted to an upper and lower median laparotomy. Group I, seven dogs, just manipulation of the spleen (sham-control); group II, nine dogs upper hemisplenectomy; group III, nine dogs, subtotal splenectomy with preservation of inferior pole, after the ligature and section of the splenic artery and vein near the hilus; group IV, thirteen dogs, total splenectomy was performed. RESULTS: Our results, when we compared to the lipid values of the different post-operative periods with preoperative data, showed that in group IV (total splenectomy) there was a significant increase of the total cholesterol in all post-operative periods (p < 0,05, p < 0,01). The high-density lipoprotein(HDL) was significantly augmented in the 7th ( p < 0,01) and 28th (p < 0,05) post-operative day and at not significantly (p > 0,05) on the 56th post-operative time. The low-density lipoprotein (LDL) increased significantly in the 56th post-operative (p < 0,01). Triglyceride and very-low density lipoproteins (VLDL) did not present significant changes. Animals of group 1 and 3 did not present significant changes. In group 2 there was a significant increased in cholesterol on the 7th post-operative day. There was no difference between the weight of the spleen remaining after partial splenectomy. CONCLUSIONS: We conclude that total splenectomy causes significant elevation in the total cholesterol, HDL and LDL, while triglycerides and VLDL don't change; - the preservation of the inferior lower half of the spleen and the preservation of the inferior pole on subtotal splenectomy protected the animal of significant changes in lipidic profile.

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          Effects of splenectomy on serum lipids and experimental atherosclerosis.

          The authors examined the effects of splenectomy on serum lipids in patients with hematologic disease, in rabbits, and also in cholesterol-fed rabbits with experimental atherosclerosis. Serum cholesterol was determined in patients with hypersplenism before and after splenectomy. Meanwhile serum lipids were determined in two groups of rabbits: splenectomy group (Spx group, n = 19), and sham operation group (Sham group, n = 14) before and after the operation. Then the rabbits were divided into four subgroups: cholesterol-fed groups--Spx-C (n = 12) and Sham-C (n = (9), and normal-chow-fed groups--Spx-N (n = 7) and Sham-N (n = 5). The Spx-C and the Sham-C rabbits were fed 1% cholesterol diet and the Spx-N and Sham-N rabbits were fed normal chow for twelve weeks. In patients preoperative serum cholesterol levels were low, and significant increase in serum cholesterol was observed following splenectomy. In rabbits, the Spx-C group showed significantly higher levels of serum cholesterol, triglycerides, and phospholipids in contrast to lower levels of high density lipoprotein cholesterol, as compared with the Sham-C group. The percentage of aortic plaque area in the Spx-C group tended to be higher than that in the Sham-C group. On the other hand, the Spx-N and the Sham-N group showed no difference in serum lipids during twelve weeks. The worsening of atherosclerosis in the Spx-C group was considered to be mainly due to an enhanced hyperlipidemia. Their results suggest a possible role of the spleen in lipid metabolism, in particular the existence of a splenic factor that can cause hypocholesterolemia in hyperplenism and can suppress hyperlipidemia.
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            Increased low-density lipoprotein levels after splenectomy: a role for the spleen in cholesterol metabolism in myeloproliferative disorders.

            Patients with myeloproliferative disorders demonstrate decreased plasma cholesterol and apolipoprotein B concentrations, and this has been related to the presence of a large spleen. Patients that underwent splenectomy in the past demonstrated normal plasma cholesterol levels. Plasma high-density lipoprotein (HDL) cholesterol and apolipoprotein A-I were also reduced in these patients, but were normal after splenectomy. To study the immediate effect of splenectomy on the plasma lipid pattern, three patients with myeloproliferative disease and a large spleen who were undergoing splenectomy were compared with two control groups, one undergoing orthopedic operations and the second, cholecystectomy. In the control groups, plasma lipids tended to decrease for the first 2 days after surgery and then returned to preoperative levels. After splenectomy, however, plasma cholesterol, low-density lipoprotein (LDL), and apolipoprotein B significantly increased, reaching maximum levels after 4 days. Plasma HDL as well as apolipoprotein A-I decreased 1 day after splenectomy, but then increased over and above their preoperative concentrations. These results suggest an important role for the spleen in cholesterol metabolism in these patients. The spleen appears to be an important site for LDL catabolism in these patients.
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              Role of the spleen in lipid metabolism.

              The frequency of ischaemic heart disease observed after splenectomy for trauma and the low cholesterol levels found in patients with hypersplenism are observations that suggest a possible role for the spleen in lipid metabolism and in the aetiology of atherosclerosis. The present study was designed to examine this role in experimental animals. Serum levels of total cholesterol, triglyceride and high-density lipoprotein (HDL) cholesterol were determined in 32 rats. The spleen was removed in 16 rats and the remaining 16 were sham operated. Half of the splenectomized and half of the remaining rats were fed on a diet rich in fat and the two other subgroups were fed normal chow. Blood tests were performed before, and 3 and 6 months after operation. A significant increase in serum triglyceride and decrease in serum HDL cholesterol levels was observed after splenectomy in rats fed normal chow compared with sham-operated rats. An increase in serum triglyceride and a decrease in serum HDL cholesterol levels was observed in both groups of rats fed normal chow plus high-fat cheese. However, these changes were more pronounced in splenectomized rats. These findings suggest that the spleen has a role in lipid metabolism in rats and may therefore influence atherosclerosis.
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                Author and article information

                Journal
                rcbc
                Revista do Colégio Brasileiro de Cirurgiões
                Rev. Col. Bras. Cir.
                Colégio Brasileiro de Cirurgiões (Rio de Janeiro, RJ, Brazil )
                0100-6991
                1809-4546
                August 2001
                : 28
                : 4
                : 264-270
                Affiliations
                [01] ES orgnameSanta Casa de Misericórdia de Vitória orgdiv1Escola Superior de Ciências
                [02] orgnameUFMG orgdiv1Faculdade de Medicina
                Article
                S0100-69912001000400006 S0100-6991(01)02800406
                10.1590/S0100-69912001000400006
                a38577bf-1cb0-4349-80a4-4883d202bd69

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 10 May 2001
                : 11 December 2000
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 7
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                SciELO Brazil

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                Artigos Originais

                Partial splenectomy,Total splenectomy,Splenectomy and Cholesterol,Esplenectomia parcial,Esplenectomia subtotal,Esplenectomia e colesterol

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