Early Surgery in Prone Position for Associated Injuries in Patients Undergoing Non‐operative Management for Splenic and Liver Injuries

Markert, Kathrin Verena; Haltmeier, Tobias; Khatsilouskaya, Tatsiana; Keel, Marius; Candinas, Daniel; Schnüriger, Beat

doi:10.1007/s00268-018-4739-y

Cited by 3 publications

(2 citation statements)

References 40 publications

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“…Another critical but often underappreciated concern with AE is the rate of major early and delayed complications, including re-bleeding, splenic infarction, abscess, acute renal insufficiency, ARDS, femoral pseudoaneurysms and other access-site complications [28,[33][34][35][36][37][38][39][40][41]. Although AE is often touted as a "spleen preserving" adjunct to NOM that helps preserve the innate immune function of the spleen, recent literature is calling this assumption into question.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic splenectomy as a definitive management option for high-grade traumatic splenic injury when non operative management is not feasible or failed: a 5-year experience from a level one trauma center with minimally invasive surgery expertise

et al. 2021

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Technique, indications and outcomes of laparoscopic splenectomy in stable trauma patients have not been well described yet. All hemodynamically non-compromised abdominal trauma patients who underwent splenectomy from 1/2013 to 12/2017 at our Level 1 trauma center were included. Demographic and clinical data were collected and analysed with per-protocol and an intention-to-treat comparison between open vs laparoscopic groups. 49 splenectomies were performed (16 laparoscopic, 33 open). Among the laparoscopic group, 81% were successfully completed laparoscopically. Laparoscopy was associated with a higher incidence of concomitant surgical procedures (p 0.016), longer operative times, but a significantly faster return of bowel function and oral diet without reoperations. No significant differences were demonstrated in morbidity, mortality, length of stay, or long-term complications, although laparoscopic had lower surgical site infection (0 vs 21%).The isolated splenic injury sub-analysis included 25 splenectomies,76% (19) open and 24% (6) laparoscopic and confirmed reduction in post-operative morbidity (40 vs 57%), blood transfusion (0 vs 48%), ICU admission (20 vs 57%) and overall LOS (7 vs 9 days) in the laparoscopic group. Laparoscopic splenectomy is a safe and effective technique for hemodynamically stable patients with splenic trauma and may represent an advantageous alternative to open splenectomy in terms of post-operative recovery and morbidity.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic splenectomy as a definitive management option for high-grade traumatic splenic injury when non operative management is not feasible or failed: a 5-year experience from a level one trauma center with minimally invasive surgery expertise

et al. 2021

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“…In polytrauma patients suffering from unstable spine fracture associated with borderline spleen or liver injuries being treated conservatively, safe surgical timing for spine fixation remains the open question. The simple act of putting the patient in prone position for two or three hours to perform a posterior fixation highlights the problem of the appropriate surgical timing keeping the patient reasonably safe [11].…”

Section: Discussionmentioning

confidence: 99%

Splenic Rupture After Minimal Invasive Lateral Retropleural Corpectomy

Cappuccio¹,

Tugnoli²,

Fidilio³

et al. 2020

SCR

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Retropleural minimal invasive approach to the thoracolumbar junction has become more popular in the last decade both for degenerative and traumatic spine surgery as it marries the advantages of direct vision typical of open surgery and the philosophy of tissue sparing which characterizes the thoracoscopic approach. Nevertheless, as with the just mentioned techniques, this approach also requires the caudal displacement of the diaphragm with the organs below including the spleen. The authors report one case of postoperative spleen disruption following a retropleural minimal invasive approach in a patient with an underlying grade II spleen lesion occurred 8 days before and considered safe by the general surgeon. We conclude that even negligible spleen injuries must be considered an absolute contraindication to thoracolumbar junction lateral approach even with minimal invasive techniques.

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Acetabular Surgery in the Prone Position Resulting in a Life-Threatening Splenic Injury

Öztürk

Yüksel

Selamoğlu

et al. 2020

JBJS Case Connector

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Case: The case reported involves a patient who developed an unexplained decrease in hemoglobin after acetabular fracture surgery in the prone position. Repeat abdominal computed tomography was remarkable for a massive subcapsular spleen hematoma secondary to rib fracture impingement, which required splenectomy. Conclusion: The spleen can be injured by a fracture rib during prone positioning for fixation of an acetabular fracture. Prone surgical positioning may cause iatrogenic intra-abdominal organ injury in patients with displaced lower rib fractures. Lateral positioning should be considered for acetabular surgery in patients with rib fractures.

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Early Surgery in Prone Position for Associated Injuries in Patients Undergoing Non‐operative Management for Splenic and Liver Injuries

Abstract: In this single-center analysis, surgery in prone position was performed in a substantial number of patients with splenic/liver injuries without increasing the fNOM rate. However, caution should be used in patients with grade IV/V splenic injuries.

Cited by 3 publications

References 40 publications

Laparoscopic splenectomy as a definitive management option for high-grade traumatic splenic injury when non operative management is not feasible or failed: a 5-year experience from a level one trauma center with minimally invasive surgery expertise

Laparoscopic splenectomy as a definitive management option for high-grade traumatic splenic injury when non operative management is not feasible or failed: a 5-year experience from a level one trauma center with minimally invasive surgery expertise

Splenic Rupture After Minimal Invasive Lateral Retropleural Corpectomy

Acetabular Surgery in the Prone Position Resulting in a Life-Threatening Splenic Injury

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