Splenic Salvage Following Iatrogenic Splenic Artery Injury Post-gastrectomy

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Vascular Surgery

Background:

• Radical gastrectomy is a standard treatment for gastric cancer.
• Postoperative complications are common, including splenic artery injuries leading to splenic infarction (SI).
• The incidence and recognition of SI post-gastrectomy are not well-established.

Observation:

• Iatrogenic splenic artery injuries during gastrectomy are common but underreported.
• Challenges in identification include post-chemotherapy fibrosis and complex splenic artery anatomy.
• Nonspecific symptoms and anatomical challenges hinder early diagnosis of SI.

Findings:

• Splenic artery injuries can lead to severe complications like hemorrhage, abscess, or rupture, potentially requiring splenectomy.
• Primary anastomosis of the splenic artery is presented as a viable technique to preserve the spleen.
• Intraoperative identification of splenic artery injuries is crucial.

Implications:

• Preserving the spleen through primary anastomosis can avoid complications associated with splenectomy.
• Improved intraoperative techniques and awareness are needed to reduce iatrogenic splenic artery injuries.
• This approach emphasizes spleen preservation in gastric cancer surgery.