title: Argon beam coagulation is superior to conventional techniques in repair of experimental splenic injury.
abstract: Present management of splenic trauma focuses on splenic preservation. However, conventional operative techniques for splenic salvage are time consuming and frequently ineffective. The purpose of this study was to assess the efficacy of the argon beam coagulator (ABC) in the management of experimental splenic injury. Ten adult miniature pigs were randomized to treatment with either conventional surgical techniques (topical Surgicel, electrocautery, suture-ligation, digital pressure) or splenic repair with the ABC. Three standard splenic injuries were made in each pig: capsular avulsion, splenic laceration, and hemisplenectomy. The ABC was more effective in treating all three types of splenic injury. The time required to achieve hemostasis and total operative time were significantly less in the group treated with the ABC for all three types of splenic injuries (p less than 0.05, Student's t-test, two sided). Operative blood loss was significantly less in the group treated with ABC for avulsion and hemisplenectomy (p less than 0.05, Student's t-test, two sided). Recurrent bleeding was significantly higher in the group treated with conventional techniques (p less than 0.001, Fisher's exact test, two-sided). We conclude that the argon beam coagulator is more effective than conventional techniques in treating experimental splenic injuries. The ABC provides more rapid and reliable hemostasis. Clinical trials using the ABC for splenic injury are warranted.
authors.affiliation: Department of Surgery, University of Pittsburgh, PA.
authors.forename: R D
authors.initials: RD
authors.lastname: Dowling
authors.forename: J
authors.initials: J
authors.lastname: Ochoa
authors.forename: S A
authors.initials: SA
authors.lastname: Yousem
authors.forename: A
authors.initials: A
authors.lastname: Peitzman
authors.forename: A O
authors.initials: AO
authors.lastname: Udekwu
mesh_terms: D000818:Animals; D001128:Argon; D016063:Blood Loss, Surgical; D006470:Hemorrhage / Q000601:surgery; D006488:Hemostasis, Surgical; D008028:Light Coagulation / Q000379:methods*; D008297:Male; D012008:Recurrence; D013154:Spleen / Q000293:injuries* / Q000601:surgery; D013161:Splenic Rupture / Q000601:surgery*; D013552:Swine; D013556:Swine, Miniature
chemical_list: D001128:Argon