Introduction of a Simple Technique for Partial Splenectomy in Multiple Trauma Patients

AUTHORS

Mehdi Eskandarlou 1 , Amir Derakhshanfar 1 , *

1 Department of Surgery, Hamadan University of Medical Sciences, Hamedan, IR Iran

How to Cite: Eskandarlou M, Derakhshanfar A. Introduction of a Simple Technique for Partial Splenectomy in Multiple Trauma Patients, Iran Red Crescent Med J. Online ahead of Print ; 15(12):9072. doi: 10.5812/ircmj.9072.

ARTICLE INFORMATION

Iranian Red Crescent Medical Journal: 15 (12); 9072
Published Online: November 30, 2013
Article Type: Research Article
Received: November 12, 2012
Accepted: October 28, 2013
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Abstract

Background: The spleen is the most commonly injured intraperitoneal organ in multiple trauma patients. Total splenectomy results in immunodeficiency and predisposes patients to certain infections.

Objectives: Performing partial splenectomy with a safe, simple, and definite technique in trauma patients with hemodynamic instability and accompanying intra-abdominal injury could play an important role in the preservation of immune function and reducing morbidity.

Patients and Methods: From 2006 to 2009, a total of 20 patients underwent partial splenectomy, at Mobasher and Besat hospitals. Patients with splenic injuries of up to stage IV and grade 3 shocks underwent partial splenectomy. The operations were performed without vascular isolation and by wedge resection of the injured splenic tissue and repair with chromic 2/0 sutures in two rows. Three months later, patients were evaluated by a Tc99 liver-spleen scan, complete blood count, and blood smear.

Results: There were 16 male and four female patients with an age range of 4 to 54 years old. Ten patients had additional intra and extra abdominal injuries. The salvaged spleen tissue was approximately 30% in nine patients, 40 to 50% in two, and more than 50% in another nine patients. The operation time was less than three hours and hospital stay was 3 to 15 days for 90% of the patients. No complications occurred after the surgery or during the follow up. For all patients, the complete blood count, peripheral smear, and liver-spleen scan were normal after six months.

Conclusions: Partial splenectomy with preserving at least 30% of the splenic tissue can be performed for trauma patients using wedge resection of the injured splenic tissue and repair by chromic 2/0 sutures in two rows. Using this technique, there is no need for vascular isolation or hemostatic materials. Splenic function is presented and associated intra and extra abdominal injuries are not contraindications for partial splenectomy.

Keywords

Wounds and Injuries Spleen Splenectomy

© 2013, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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