Retrospective Analysis on Spleen-preserving Treatment Methods for Patients with Splenic Injury_West China Medical Journal

Authors：

 WANGXue-wen , QINGXiao-song , YANGSen ,  LAIZhao

Department of Hepatobiliary Surgery, the Forth People's Hospital of Zigong City, Zigong, Sichuan 643000, P. R. China;

Corresponding author：

LAIZhao, Email: 1489201539@qq.com

Keywords：

Splenic rupture; Spleen-preserving treatment; Combined treatment; Spleen-preserving surgery; Non-surgical treatment

DOI：

10.7507/1002-0179.20150469

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the treatment effects and success rate of spleen-preserving treatments for patients with splenic injury, and to explore the ideal spleen-preserving treatment for different types of splenic injury. Method We retrospectively analyzed the clinical data of 136 patients with splenic injury who underwent spleen-preserving treatment in the Department of Hepatobiliary Surgery between July 1998 and December 2010. And the treatment effects of different combined treatment methods were compared and studied. Results Twenty-seven patients were treated without surgery; 23 underwent vascular suture combined with fibrin glue treatment; 26 accepted splenic artery ligation, partial suture and fibrin glue treatment; 20 underwent ultrasonic scalpel partial splenectomy and wound spray fibrin glue treatment; 17 accepted splenic artery ligation and RF hemostatic cutter row spleen resection; and 23 accepted laparoscopic ultrasonic scalpel with partial splenectomy and wound spray fibrin glue treatment. Spleen-preserving succeeded in 131 cases (95.58%) and failed in 5 cases (4.42%) without any deaths. Conclusions In the treatment of splenic injury, the success rate of different methods of spleen-preserving is close. The success rate of combined use of several spleen-preserving methods together is higher. Under the principle of "Save lives first, and preserve spleen second", we should carry out individualized treatment plan for the patients based on patients' general condition, the extent and grade of splenic rupture, and medical equipment and technical conditions. For those medical units with good treatment conditions, combined spleen-preserving treatment can be performed.

Citation： WANGXue-wen, QINGXiao-song, YANGSen, LAIZhao. Retrospective Analysis on Spleen-preserving Treatment Methods for Patients with Splenic Injury. West China Medical Journal, 2015, 30(9): 1641-1644. doi: 10.7507/1002-0179.20150469 Copy

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1. 吴在德, 吴肇汉. 外科学[M]. 7版. 北京:人民卫生出版社, 2008:404.
2. Benoit S. Median and long term complications of splenectomy[J]. Ann Chir, 2000, 125(4):317-324.
3. 徐永波, 张廷国, 褚海波. 脾功能亢进与炎症细胞反应[J]. 中国现代普通外科进展, 2013, 16(2):161-164.
4. Daude N. Prion diseases and the spleen[J]. Viral Immunol, 2004, 17(3):334-349.
5. 臧建民, 赵振生. 脾破裂行保脾手术与全脾切除术的早期感染发生率分析[J]. 中国基层医药, 2012, 19(15):2287-2288.
6. 罗宏宇, 张桂平, 安丰山. 脾破裂的保脾手术治疗:附26例报告[J]. 中国普通外科杂志, 2006, 15(5):397-398.
7. 乔海泉, 姜宪. 正确认识脾功能,合理开展脾手术[J]. 中华普通外科学文献:电子版, 2008, 2(6):439-441.
8. 乔海泉, 姜洪池, 代文杰. 脾损伤新分级的意义[J]. 腹部外科, 2001, 14(4):197-198.
9. 夏穗生. 发展现代脾脏外科的关键问题[J]. 实用外科杂志, 1992(10):5-6.
10. Fang JF, Wong YC, Lin BC, et al. Usefulness of multidetector computed tomography for the initial assessment of blunt abdominal trauma patients[J]. World J Surg, 2006, 30(2):176-182.
11. 周理好, 项柱. 胃癌手术致脾损伤的预防及处理技巧[J]. 安徽医学, 2013, 34(7):914-916.
12. 夏溟, 韩精超, 白焱, 等. 泌尿外科手术中脾损伤的防治体会[J]. 中华泌尿外科杂志, 2012, 33(11):859-862.
13. 黄洁夫. 腹部外科学[M]. 北京:人民卫生出版社, 2001:1542.
14. 潘留勇. 外伤性脾脏破裂保脾治疗84例临床分析[J]. 广西医学, 2012, 34(9):1274-1275.
15. 张贤飞, 陆泉健. 外伤性脾破裂术式探讨[J]. 中国实用外科杂志, 2000, 20(4):237.
16. Chan CW, Crafton E, Fan HN, et al. Interferon-producing killer dendritic cells provide a link between innate and adaptive immunity[J]. Nat Med, 2006, 12(2):207-213.
17. Weber JC, Navarra G, Jiao LR, et al. New technique for liver resection using heat coagulative necrosis[J]. Ann Surg, 2002, 236(5):560-563.
18. 姜洪池, 陆朝阳. 关于微创手术入路与整体损伤比的思考[J]. 中国实用外科杂志, 2005, 25(6):323-325.
19. Pickhardt B, Moore EE, Moore FA, et al. Operative splenic salvage in adults:a decade perspective[J]. J Trauma, 1989, 29(10):1386-1391.
20. 罗麒, 郭国宁. 脾损伤67例的临床诊治[J]. 中国基层医药, 2012, 19(12):1833-1834.

West China Medical Journal

Retrospective Analysis on Spleen-preserving Treatment Methods for Patients with Splenic Injury

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