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Splenorrhaphy for splenic trauma.

M E Weinstein, G G Govin, C L Rice

    The Journal of Trauma
    |September 1, 1979
    PubMed
    Summary
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    Splenic repair (splenorrhaphy) is feasible for blunt abdominal trauma, with 18 of 30 patients having their spleen salvaged. Postoperative spleen scans confirmed functioning splenic tissue in all cases.

    Area of Science:

    • Trauma Surgery
    • Surgical Oncology
    • Abdominal Surgery

    Background:

    • Blunt abdominal trauma frequently causes splenic injuries.
    • Splenectomy has been the traditional treatment, but spleen preservation is increasingly preferred.

    Purpose of the Study:

    • To evaluate the feasibility and outcomes of splenorrhaphy versus splenectomy in patients with blunt splenic trauma.
    • To assess the efficacy of spleen-preserving techniques in managing splenic injuries.

    Main Methods:

    • Retrospective analysis of 30 consecutive patients with blunt splenic trauma.
    • Intraoperative decision-making regarding splenorrhaphy or splenectomy.
    • Detailed documentation of surgical procedures, including debridement, topical hemostatic agents, partial splenectomy, and vessel ligation.

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  • Postoperative assessment including blood transfusion requirements, complications, and spleen scans.

    • Main Results:

    • 18 out of 30 patients underwent splenorrhaphy, while 12 required splenectomy.
    • No significant differences in age, injury mechanism, or associated injuries between the groups.
    • Splenorrhaphy techniques varied, including debridement with Avitene, hemisplenectomy, partial splenectomy, oversewing, and vessel ligation.
    • No postoperative complications were reported for splenorrhaphy patients.
    • Spleen scans in 16 patients confirmed functioning splenic tissue post-splenorrhaphy.

    Conclusions:

    • Splenorrhaphy is a feasible and safe alternative to splenectomy for blunt splenic trauma.
    • Spleen preservation techniques can successfully maintain splenic function.
    • Further research into optimal splenorrhaphy techniques is warranted.