[Functions of the splenic remnant after subtotal splenectomy for treatment of severe splenic injuries].
OBJECTIVE
To evaluate clinical and laboratory variables in patients submitted to subtotal splenectomy.


METHODS
34 patients with severe trauma of the spleen and its pedicle were studied: 25 patients were submitted to subtotal splenectomy, preserving only the upper pole of the spleen (Group I), 9 were submitted to total splenectomy (Group II), and other 22 people with intact spleen were the control (Group III). Immediate and late postoperative complications were investigated. Laboratory exams were performed in the late postoperative period (red blood cells, hemoglobin, white blood cells, platelets and Howell-Jolly bodies). We studied the B- and T-lymphocyte counts and the immunoglobulins A, G and M (IgA, IgG and IgM) levels. Splenic scintigraphy with technetium 99mTc sulfur colloid was carried out on all patients.


RESULTS
Group II presented Howell-Jolly bodies increased and low level of immunoglobulin M. The splenic scintigraphy demonstrated the viability and the filtering function of the splenic remnant in Group I.


CONCLUSIONS
Subtotal splenectomy is a surgical alternative technique for treatment of severe distal injuries of the spleen or when its main vessels are damaged.
Universidade Federal de Minas Gerais (UFMG) e Hospital João XXIII (FHEMIG-Fundação Hospitalar do Estado de Minas Gerais).
Viviam
V
Resende
Andy
A
Petroianu
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D008214:Lymphocytes / Q000097:blood; D008297:Male; D011184:Postoperative Period; D019275:Radiopharmaceuticals; D013154:Spleen / Q000293:injuries* / Q000502:physiology*; D013156:Splenectomy / Q000379:methods / Q000592:standards; D013671:Technetium Tc 99m Sulfur Colloid
D007136:Immunoglobulins; D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid