title: [Iatrogenic splenic injuries in surgery of colorectal carcinoma: impact on the oncological long-term of outcome].
abstract: BACKGROUND
  Iatrogenic lesions of the spleen during surgery of colorectal carcinoma is considered a significant risk factor for a worse early postoperative outcome. With regard to the impact of iatrogenic splenic lesions particularly associated with splenectomy on the oncological long-term outcome, only limited valid data are available.
  
  
  METHODS
  Data obtained in a prospective multicenter observational study were analyzed. The study enrolled 45,265 patients with surgery for colorectal carcinoma in curative and palliative intentions during the study period from 01 January 2000 to 31 December 2004, with regard to the impact of iatrogenic splenic lesions on survival rates.
  
  
  CONCLUSIONS
  Follow-up data with corresponding informed consent were obtained from 564 patients with iatrogenic splenic lesions, resulting in a follow-up rate of 99.8 %. The median follow-up period was 50.2 months. The median 5-year overall survival was 4.8 years in group I (splenic lesion with splenectomy) and in group II (splenic lesion with organ preservation) 8.0 years (p = 0.009). Between group II (splenic lesion with organ preservation) and group III (control group with no splenic lesion) there were no significant differences with regard to long-term survival. Using multivariate Cox regression analysis, iatrogenic splenic lesions with splenectomy were identified as an independent risk factor for a worse oncological long-term outcome.
authors: An-Institut für Qualitätssicherung in der operativen Medizin gGmbH an der Otto-von-Guericke-Universität, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
authors: R
authors: R
authors: Steinert
authors: M
authors: M
authors: Depel
authors: A
authors: A
authors: Schmidt
authors: H
authors: H
authors: Ptok
authors: F
authors: F
authors: Meyer
authors: S
authors: S
authors: Wolff
authors: R
authors: R
authors: Otto
authors: I
authors: I
authors: Gastinger
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D010166:Palliative Care; D011183:Postoperative Complications / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy; D016019:Survival Analysis; D015996:Survival Rate