title: A solution to the negative effects of splenectomy during colorectal trauma and surgery: an experimental study on splenic autotransplantation to the groin area.
abstract: BACKGROUND
  Splenectomy after combined colosplenic trauma or iatrogenic splenic injury during colorectal surgery associates with worse short- and long-term outcomes, including reduced survival in patients with colorectal cancer. Splenic autotransplantation may improve the outcomes of such patients. Omental splenic transplantation is the standard procedure but may be difficult when performing laparoscopic colorectal surgery or when total or subtotal omentectomy is required. This animal model study was performed to evaluate the impact of splenic autotransplantation to the groin area on colonic wound healing.
  
  
  METHODS
  Thirty rats were divided into three groups of ten animals. One group underwent colon anastomosis and sham splenectomy, the second underwent colon anastomosis and splenectomy, and the third underwent colon anastomosis, splenectomy, and intramuscular autotransplantation of the spleen. On postoperative day 7, anastomotic healing was evaluated by measuring bursting pressure and hydroxyproline levels. The third group was subjected to scintigraphy before sacrifice to assess whether the transplant was functional.
  
  
  RESULTS
  The mortality rates of the sham, splenectomized, and transplanted animals were 0 %, 30 %, and 20 %, respectively: the splenectomized animals had significantly lower mean bursting pressures than the other two groups (p = 0.002). The mean hydroxyproline levels of the three groups were 467.4, 335.3, and 412.7 mg hydroxyproline/g protein, respectively (p = 0.0856). Nine of the ten transplanted animals (90 %) had splenic activity on scintigraphy.
  
  
  CONCLUSIONS
  Splenectomy impaired the healing of the colonic anastomosis. This effect was largely reversed by splenic autotransplantation. Intramuscular autotransplantation to the groin area appears to be feasible and effective.
authors.affiliation: Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Barajyolu Caddesi Flora Evleri, E-15 Yenisehir/Atasehir, PB, 34758, Istanbul, Turkey. borakarip@gmail.com.
authors.forename: Bora
authors.initials: B
authors.lastname: Karip
authors.affiliation: Department of General Surgery, Kütahya Evliya Çelebi Training and Research Hospital, Kütahya, Turkey. metinmestan@gmail.com.
authors.forename: Metin
authors.initials: M
authors.lastname: Mestan
authors.affiliation: Department of General Surgery, Özel Acıbadem Hospital, Bursa, Turkey. ozgen006@yahoo.com.
authors.forename: Özgen
authors.initials: Ö
authors.lastname: Işık
authors.affiliation: Department of General Surgery, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey. mtnkeskin@yahoo.com.
authors.forename: Metin
authors.initials: M
authors.lastname: Keskin
authors.affiliation: Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Barajyolu Caddesi Flora Evleri, E-15 Yenisehir/Atasehir, PB, 34758, Istanbul, Turkey. hkafkas@hotmail.com.
authors.forename: Kafkas
authors.initials: K
authors.lastname: Çelik
authors.affiliation: Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Barajyolu Caddesi Flora Evleri, E-15 Yenisehir/Atasehir, PB, 34758, Istanbul, Turkey. yaliniscan@gmail.com.
authors.forename: Yalın
authors.initials: Y
authors.lastname: İşcan
authors.affiliation: Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Barajyolu Caddesi Flora Evleri, E-15 Yenisehir/Atasehir, PB, 34758, Istanbul, Turkey. cerrah@gmail.com.
authors.forename: Kemal
authors.initials: K
authors.lastname: Memişoğlu
mesh_terms: D000818:Animals; D003106:Colon / Q000293:injuries* / Q000601:surgery; D004195:Disease Models, Animal; D005260:Female; D006119:Groin / Q000601:surgery*; D006801:Humans; D017208:Rats, Wistar; D012007:Rectum / Q000293:injuries* / Q000601:surgery; D013154:Spleen / Q000293:injuries* / Q000601:surgery*; D013156:Splenectomy; D014182:Transplantation, Autologous; D014945:Wound Healing