A safe surgical technique for the partial resection of the ruptured spleen. A clinical report.
A consecutive series of 11 patients with an acute blunt splenic injury were treated with a 'safe resection' technique. 57% of the injured spleens (range 35-100%) were saved. None of the patients had any signs of secondary bleeding in control CT scan and the mortality was zero. No second-look laparotomies were performed. Follow-up time was at least two months (range 2 month-6 yr). Operation time was in average 120 min. Total mean peroperative bleeding was 1400 ml. Partial resection may offer patient a change for normal function of the injured spleen. However, it is not yet known what is the critical mass of spleen tissue needed for humans. The follow-up time of the present study is still too short to estimate this fact, but further studies may show the benefit of the present method in avoiding serious long term immunological complications of splenectomy. This present study introduces a novel technique for partial resection of injured spleen. Operation can be performed safely and quickly with a complication risk comparable to splenectomy. Resection is applicable even for multi-trauma patients.
Tulikoura
I
I
Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland.
Lassus
J
J
Konttinen
Y T
YT
Juutilainen
T
T
Santavirta
S
S
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D001810:Blood Volume; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology; D013161:Splenic Rupture / Q000000981:diagnostic imaging / Q000276:immunology / Q000601:surgery*; D013526:Surgical Mesh; D013514:Surgical Procedures, Operative / Q000379:methods*; D014057:Tomography, X-Ray Computed