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[Alternatives to splenectomy in the surgical treatment of splenic injuries]
J Uroz Tristán1, X García Urgellés, F Martínez Lagares
1Servicio de Cirugía Pediátrica, Hospital Materno-Infantil, Las Palmas de Gran Canaria.
Insights
Surgical intervention for pediatric splenic trauma is rare. This study highlights successful splenic preservation in severe pediatric splenic injuries using reabsorbable mesh or splenic artery embolization.
Area of Science:
- Pediatric surgery
- Trauma management
- Surgical innovation
Context:
- Children with splenic trauma are usually managed non-operatively.
- Surgical intervention for splenic injuries in children is infrequent.
- Splenic preservation is a key goal when surgery is necessary.
Purpose:
- To present the authors' experience in managing severe splenic injuries in children over four years.
- To evaluate the effectiveness of operative splenic preservation techniques and percutaneous embolization.
Summary:
- Nine cases of severe pediatric splenic injury were reviewed.
- Six patients underwent operative repair using a reabsorbable mesh for splenic preservation.
- Three patients were treated with percutaneous selective splenic artery embolization under fluoroscopic guidance.
Impact:
- Demonstrates successful outcomes for splenic preservation in severe pediatric splenic trauma.
- Highlights the utility of reabsorbable mesh and embolization as viable treatment options.
- Contributes to the understanding of advanced management strategies for pediatric splenic injuries.
Abstract:
Children with splenic trauma are managed conservatively in most circumstances, and the need for surgical interventions is very rare. When a surgical exploration is mandatory, splenic preservation is a worthwhile objective, using various suture methods, biomaterials, or resorbable prosteses. We present our experience over the 4 years with 9 severe splenic injuries. Six of this patients were treated operatively with a reabsorvable mesh, while the other 3 were managed percutaneosly by selective embolization of the splenic artery under fluoroscopic control. We describe our experience in the treatment of the splenic injuries in the last four years.