A four-year experience with splenectomy versus splenorrhaphy

Area of Science:

• Trauma Surgery
• Surgical Oncology
• Emergency Medicine

Background:

• Splenic injuries are common in trauma patients.
• Treatment options include splenectomy (spleen removal) and splenorrhaphy (spleen repair).
• The choice of treatment impacts patient outcomes.

Purpose of the Study:

• To evaluate the outcomes of splenectomy versus splenorrhaphy in trauma patients.
• To determine the feasibility and success rates of splenorrhaphy based on injury grade.
• To compare the mortality rates associated with splenectomy and splenorrhaphy.

Main Methods:

• Retrospective review of 326 patients treated between 1980-1984.
• Classification of splenic injuries by severity (Grades 1-5).
• Analysis of injury mechanisms, treatment performed, and patient outcomes.

Main Results:

• Splenectomy was performed in 55.4% and splenorrhaphy in 44.6% of injured spleens.
• Splenorrhaphy success rates varied by injury grade: 88.5% for Grade 1-2, 61.5% for Grade 3, and 7.7% for Grade 4-5.
• Splenectomy had a mortality rate 13.5 times higher than splenorrhaphy.

Conclusions:

• Splenorrhaphy is a viable and safer option for approximately 50% of splenic trauma patients.
• Splenectomy is typically reserved for severe injuries and associated intra-abdominal trauma.
• Prioritizing splenorrhaphy when feasible can significantly reduce mortality in splenic trauma management.