Splenectomy proportions are still high in low-grade traumatic splenic injury
Ahmet Korkut Belli1, Önder Özcan1, Funda Dinç Elibol2, Cenk Yazkan1, Cem Dönmez1, Ethem Acar3, Okay Nazlı1
1Departmant of General Surgery, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
2Department of Radiology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
3Department of Emergency Medicine, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
Abstract
Objective: The spleen is the most vulnerable organ in blunt abdominal trauma. Spleen-preserving treatments are non-operative management with or without splenic angioembolization, partial splenectomy, and splenorrhaphy. The aim of the present study was to determine the rate of SPTs and to evaluate the usefulness of Injury Severity Score after traumatic splenic injury.
Material and Methods: We searched our institution’s database between May 2012 and December 2015. Patients’ clinicopathological features, surgeon’s title, type of treatment, admission and discharge dates, duration of surgery, intensive care unit requirement, and Glasgow Coma Scale were recorded.
Results: The mean age of patients was 33.36±11.58 years. Of the 33 patients, 26 (78.8%) were males, and 7 (21.2%) were females. Thirty (90.9%) had total splenectomy (TS), and 3 (9.1%) had spleen preserving treatment (2 Nonoperative management and 1 partial splenectomy). No fatal hemorrhage developed after nonoperative management. Exitus rates were 5/30 (15.1%) and 0/3 in the total splenectomy and spleen preserving treatment groups, respectively. Of the 18 hemodynamically stable patients, only 2 (11.1%) had spleen preserving treatment. Of the 19 patients with grade I–III splenic injury, only 3 (15.8%) had spleen preserving treatment. For academic and non-academic surgeons, spleen preserving treatment rates were 3/11 (27.3%) and 0/22 (0%), respectively (p<0.05). Injury severity score and mean arterial pressure, number of transfusions, control hematocrit, and GCS had statistically significant relationships.
Conclusions: Spleen preserving treatment proportions were low after traumatic splenic injury. Following trauma, guidelines will not only improve spleen preservation rates but also improve the overall health status of the patients and it will also prevent complications of splenectomy.
Keywords: Splenectomy, surgery, emergency, spleen-preserving treatment, trauma
Cite this paper as: Belli AK, Özcan Ö, Dinç Elibol F, Yazkan C, Dönmez C, Acar E, Nazlı O. Splenectomy proportions are still high in low-grade traumatic splenic injury. Turk J Surg 2018; 34: 106-110.
This study was presented at the ‘’20th National Surgical Congress’’, 13-17 April 2016, Antalya, Turkey.
The authors declared that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects.
Written informed consent was obtained from patient who participated in this study.
Externally peer-reviewed.
Concept - A.K.B.; Design - A.K.B.; Supervision - A.K.B.; Resource - A.K.B., Ö.Ö., C.D., O.N.; Materials - A.K.B., Ö.Ö., C.D., O.N.; Data Collection and/or Processing - A.K.B., F.D.E., C.Y., E.A.; Analysis and/or Interpretation - A.K.B.; Literature Search - A.K.B, C.Y.; Writing Manuscript - A.K.B.; Critical Reviews - A.K.B., Ö.Ö., O.N.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.