title: Emergency treatment of splenic injury in a novel mobile minimally invasive interventional shelter following disaster: a feasibility study.
abstract: BACKGROUND
  There has been an increase in natural disasters in recent years, which leads to a great number of injuries and deaths. It still remains an unsolved problem to treat patients with vascular injury of solid organs effectively following natural disasters, but on-spot emergency interventional transcatheter arterial embolization (TAE) has been highly recommended to cure serious vascular injury of solid organs nowadays. Spleen is the most vulnerable abdominal organ, severe arterial hemorrhage of which can cause death if untreated timely. In this research, we aimed to study the possibility of performing emergency surgical intervention in mobile minimally invasive interventional shelter for splenic injury in the case of natural disasters.
  
  
  METHODS
  First, the mobile minimally invasive interventional shelter was unfolded in the field, and then disinfection and preoperative preparation were performed immediately. Eight large animal models of splenic injury were created, and angiograms were performed using a digital subtraction angiography machine in the mobile minimally invasive interventional shelter, and then the hemostatic embolizations of injured splenic artery were performed following the established convention of rapid intervention therapy. The operating time was recorded, and the survival condition and postoperative complications were observed for two weeks.
  
  
  CONCLUSIONS
  The average time of unfolding the shelter, and performing disinfection and preoperative preparation was 33 ± 7 min. The number of colonies in the sterilized shelter body was 86 ± 13 cfu/m(3). The average TAE time was 31 ± 7 min. All the hemostatic embolizations of splenic injury were performed successfully in the mobile minimally invasive interventional shelter during the operation. A pseudoaneurysm was found in an animal model using angiography two weeks after the operation. The primary clinical success rate of embolization was 87.5%. The two-week survival rate in all animal models of splenic injury was 100%.
  
  
  CONCLUSIONS
  Our findings in the current study demonstrate that the mobile minimally invasive interventional shelter can be adapted to the field perfectly and complete emergency surgical intervention for splenic injury efficiently and safely. Therefore, on-spot emergency interventional TAE for vascular injury of solid organs (e.g. spleen) in mobile minimally invasive interventional shelter is available and effective.
authors.forename: Tianming
authors.initials: T
authors.lastname: Yao
authors.forename: Jingjing
authors.initials: J
authors.lastname: Rong
authors.forename: Ming
authors.initials: M
authors.lastname: Liang
authors.forename: Jingyang
authors.initials: J
authors.lastname: Sun
authors.forename: Fengqi
authors.initials: F
authors.lastname: Xuan
authors.forename: Lijun
authors.initials: L
authors.lastname: Zhao
authors.forename: Xiaozeng
authors.initials: X
authors.lastname: Wang
authors.forename: Fei
authors.initials: F
authors.lastname: Li
authors.forename: Geng
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Cardiology, The general hospital of Shenyang Military Region, Shenyang 110016, China. hanyl@medmail.com.cn.
authors.forename: Yaling
authors.initials: Y
authors.lastname: Han
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D000552:Ambulances; D000792:Angiography; D000818:Animals; D004190:Disasters; D004195:Disease Models, Animal; D004285:Dogs; D004621:Embolization, Therapeutic / Q000379:methods*; D004638:Emergency Treatment / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D015641:Radiography, Interventional; D013154:Spleen / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*
references.citation: J Trauma Acute Care Surg. 2012 Nov;73(5):1100-5
references.pmid: 22832765
references.citation: Injury. 2012 Jan;43(1):62-6
references.pmid: 20673894
references.citation: Crit Care Clin. 2004 Jan;20(1):119-34
references.pmid: 14979333
references.citation: J Trauma. 2010 Dec;69(6):1423-6
references.pmid: 20571451
references.citation: S Afr Med J. 2010 Jan 29;100(2):105-8
references.pmid: 20459914
references.citation: Arch Surg. 2003 Aug;138(8):844-51
references.pmid: 12912742
references.citation: J Trauma. 1995 Aug;39(2):325-30
references.pmid: 7674402
references.citation: J Trauma. 2010 Nov;69(5):1126-30; discussion 1130-1
references.pmid: 21068617
references.citation: Cochrane Database Syst Rev. 2005 Apr 18;(2):CD004446
references.pmid: 15846717
references.citation: J Trauma. 2000 Aug;49(2):177-87; discussion 187-9
references.pmid: 10963527
references.citation: Injury. 2012 Feb;43(2):180-3
references.pmid: 21696725
references.citation: J Trauma. 2004 Apr;56(4):768-72; discussion 773
references.pmid: 15187739
references.citation: J Trauma. 2005 Mar;58(3):492-8
references.pmid: 15761342
references.citation: Radiology. 1991 Oct;181(1):189-96
references.pmid: 1887032
references.citation: J Trauma. 2011 Oct;71(4):898-903; discussion 903
references.pmid: 21986737
references.citation: J Trauma. 1996 Jun;40(6):867-74
references.pmid: 8656471
references.citation: Radiol Med. 2011 Apr;116(3):454-65
references.pmid: 21225360
references.citation: Cardiovasc Intervent Radiol. 2012 Aug;35(4):795-806
references.pmid: 21674281
references.citation: J Trauma Acute Care Surg. 2012 Nov;73(5):1221-4
references.pmid: 23117382
references.citation: Injury. 2014 Jan;45(1):122-7
references.pmid: 24054002
references.citation: J Trauma Acute Care Surg. 2013 Jul;75(1):69-74; discussion 74-5
references.pmid: 23778441
references.citation: J Vasc Interv Radiol. 2001 Feb;12(2):209-14
references.pmid: 11265885
references.citation: Cardiovasc Intervent Radiol. 2012 Feb;35(1):76-81
references.pmid: 21431976
references.citation: Injury. 2014 Jan;45(1):160-3
references.pmid: 23137799
references.citation: Chin Med J (Engl). 2012 Mar;125(6):995-9
references.pmid: 22613520