Splenorrhaphy in patients with abdominal trauma

Area of Science:

• Trauma Surgery
• Surgical Management
• Organ Preservation

Background:

• Splenorrhaphy is increasingly utilized for managing splenic trauma.
• It is advocated to prevent postsplenectomy sepsis.
• This study compares splenectomy and splenorrhaphy outcomes.

Purpose of the Study:

• To evaluate the safety and efficacy of splenorrhaphy versus splenectomy.
• To identify factors influencing the choice of surgical management.
• To assess complication rates associated with each procedure.

Main Methods:

• Retrospective review of 42 patients with splenic trauma (penetrating or blunt).
• Patients were treated with either splenectomy (26) or splenorrhaphy (16).
• Data collected included demographics, injury mechanism, associated injuries, operative details, fluid requirements, and complications.

Main Results:

• Splenectomy patients had more associated injuries, intraoperative hypotension, and higher fluid requirements.
• Splenectomy was associated with more postoperative complications.
• No complications were reported for splenorrhaphy patients.
• Most splenectomy patients (22/26) had unsalvageable spleens.

Conclusions:

• Splenorrhaphy is a viable option for stable patients with potentially salvageable spleens.
• Spleen repair does not appear to increase surgical risk.
• Prioritizing splenorrhaphy may reduce complications compared to splenectomy.