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. 吳在德, 吳肇漢. 外科學[M]. 7版. 北京:人民衛生出版社, 2008:404.
2. Benoit S. Median and long term complications of splenectomy[J]. Ann Chir, 2000, 125(4):317-324.
3. 徐永波, 張廷國, 褚海波. 脾功能亢進與炎癥細胞反應[J]. 中國現代普通外科進展, 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, 趙振生. 脾破裂行保脾手術與全脾切除術的早期感染發生率分析[J]. 中國基層醫藥, 2012, 19(15):2287-2288.
6. 羅宏宇, 張桂平, 安豐山. 脾破裂的保脾手術治療:附26例報告[J]. 中國普通外科雜志, 2006, 15(5):397-398.
7. 喬海泉, 姜憲. 正確認識脾功能,合理開展脾手術[J]. 中華普通外科學文獻:電子版, 2008, 2(6):439-441.
8. 喬海泉, 姜洪池, 代文杰. 脾損傷新分級的意義[J]. 腹部外科, 2001, 14(4):197-198.
9. 夏穗生. 發展現代脾臟外科的關鍵問題[J]. 實用外科雜志, 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, 項柱. 胃癌手術致脾損傷的預防及處理技巧[J]. 安徽醫學, 2013, 34(7):914-916.
12. 夏溟, 韓精超, 白焱, 等. 泌尿外科手術中脾損傷的防治體會[J]. 中華泌尿外科雜志, 2012, 33(11):859-862.
13. 黃潔夫. 腹部外科學[M]. 北京:人民衛生出版社, 2001:1542.
14. 潘留勇. 外傷性脾臟破裂保脾治療84例臨床分析[J]. 廣西醫學, 2012, 34(9):1274-1275.
15. 張賢飛, 陸泉健. 外傷性脾破裂術式探討[J]. 中國實用外科雜志, 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, 陸朝陽. 關于微創手術入路與整體損傷比的思考[J]. 中國實用外科雜志, 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. 羅麒, 郭國寧. 脾損傷67例的臨床診治[J]. 中國基層醫藥, 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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