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The risk of splenorrhaphy
1Department of Surgery, University of California, Davis Medical Center, Sacramento 95817.
Archives of Surgery (Chicago, Ill. : 1960)
|September 1, 1988
Summary
Splenic salvage via splenorrhaphy has risks. Complications from spleen repair, including bleeding and transfusions, may outweigh the dangers of spleen removal (splenectomy).
Area of Science:
- Surgical outcomes
- Trauma surgery
- Spleen injury management
Background:
- Overwhelming postsplenectomy sepsis is a significant risk after spleen removal.
- This fear drives enthusiasm for splenic salvage, potentially prioritizing spleen preservation over patient safety.
Purpose of the Study:
- To evaluate the complication rate of splenorrhaphy for major splenic injuries.
- To compare the risks of splenic salvage with the risks of postsplenectomy sepsis.
Main Methods:
- Retrospective review of 119 patients with major splenic injuries treated with splenorrhaphy.
- Analysis of complications directly attributed to the splenorrhaphy procedure.
Main Results:
- 11.8% of patients (11/119) experienced 14 complications related to splenorrhaphy.
- Complications included rebleeding requiring splenectomy and persistent bleeding necessitating transfusions or reoperation.
- Blood transfusion, often required for splenorrhaphy, carries risks that may exceed those of postsplenectomy sepsis.
Conclusions:
- Splenic salvage through splenorrhaphy can lead to significant complications.
- When blood transfusion is necessary for splenorrhaphy, splenectomy without transfusion may be a safer treatment option.