[The organ-preserving surgical treatment of the splenic rupture after the blunt abdominal trauma].
The outcomes of 383 cases of heavy combined traumas (n=273) and isolated (n=110) closed injuries of the abdomen with spleen damage were analyzed. The overall mortality was 11.74% (n=45), whereas the mortality rate during the first day after admission was 7.83% (n=30). Removal of a spleen was executed at 228 patients. The spleen-preserving operation with ligation of splenic artery, was performed in 155 patients. The optimal level of the splenic artery ligation proved to be in its proximal and median parts. The postoperative CT-angiogarphy and Doppler US scanning together with the three-dimensional reconstruction confirmed that blood supply of the body and tail of the pancreas was satisfactory thanks to the natural collateral blood circulation. The dramatic decrease in lethality and of postoperative complication rates allows to consider spleen-preserving resections to be a good alternative to spleenectomy.
A N
AN
Alimov
A R
AR
Zubarev
A D
AD
Priamikov
V A
VA
Alimov
A A
AA
Sukiasian
I V
IV
Murashina
É P
ÉP
Safronov
Iu E
IuE
Kim
D000007:Abdominal Injuries / Q000150:complications; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000209:etiology / Q000517:prevention & control; D011379:Prognosis; D011859:Radiography; D013154:Spleen / Q000098:blood supply / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D013161:Splenic Rupture / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications