Improved outcome of adult blunt splenic injury: A cohort analysis

Rajani, Ravi R.; Claridge, Jeffrey A.; Yowler, Charles J.; Patrick, Pamela K.S.; Wiant, Amanda; Summers, Jessica I.; McDonald, Amy A.; Como, John J.; Malangoni, Mark A.

doi:10.1016/j.surg.2006.07.005

Cited by 90 publications

(61 citation statements)

References 23 publications

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“…NOM has been evaluated in several [5][6][7][8][9][10]14], diventando, così, lo standard di cura nei pazienti che presentano valori di emodinamica stabile al momento del ricovero. Su queste basi, l'integrazione di embolizzazione percutanea (SAE) e del NOM ha raggiunto un tasso di salvataggio splenico tra 73%-96%, come riportato da altre esperienze [13][14][15][16][17][18][19][20][21]. Inoltre, SAE rappresenta un'opzione affi dabile per i pazienti con gravi lesioni della milza, considerati a rischio di fallimento di un approccio conservativo.…”

Section: Discussionunclassified

“…D'altra parte la milza residua è suffi ciente a mantereports, which indicate overall spleen salvage of 57%-91% [5][6][7][8][9][10]14], becoming the standard of care in patients presenting with stable haemodynamic values on admission. Thus, integration of percutaneous embolisation and NOM has achieved a spleen salvage rate of 73%-96%, as reported by other experiences [13][14][15][16][17][18][19][20][21]. Furthermore, SAE represents a reliable option for patients with major splenic injuries previously considered to be at high failure risk for a conservative approach.…”

Section: Discussionmentioning

confidence: 99%

“…Diversi materiali sono stati proposti per questo utilizzo: pitressina, trombi autologhi e, più recentemente, particelle riassorbibili e spirali metalliche RM compatibili [12][13][14][15][16][17][18][19][20][21][22]. Le particelle riassorbibili hanno un diametro fi no a 1000 micron.…”

Section: Discussionunclassified

“…L'embolizzazione dell'arteria splenica (SAE) nel trauma addominale chiuso è stato proposto per la prima volta da Scalfani et al nel 1991 [12] per ridurre l'incidenza di recidiva di sanguinamento. Diversi autori hanno inoltre valutato l'effi cacia di questa procedura come integrazione al NOM in lesioni spleniche [13][14][15][16][17][18][19][20][21][22]. L'obiettivo di questo lavoro, concentrato sul periodo periprocedurale di 30 giorni, è quello di valutare i risultati della nostra esperienza di embolizzazione percutanea in pazienti con lesioni spleniche sanguinanti.…”

Section: Riassuntounclassified

“…Several authors have further evaluated the effectiveness of this procedure as an integration of NOM in splenic injury [13][14][15][16][17][18][19][20][21][22]. The aim of this study, which focuses on the periprocedural 30-day period, was to evaluate the results of our experience with transarterial embolization in patients with blunt splenic injury.…”

Section: Introductionmentioning

confidence: 99%

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The role of arterial embolization in blunt splenic injury

et al. 2011

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Section: Discussionunclassified

Section: Discussionmentioning

confidence: 99%

Section: Discussionunclassified

Section: Riassuntounclassified

Section: Introductionmentioning

confidence: 99%

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The role of arterial embolization in blunt splenic injury

et al. 2011

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Non-operative management and immune function after splenic injury

Skattum

Næss

Gaarder

2011

British Journal of Surgery

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Background: There is still considerable controversy about the importance and method of preserving splenic function after trauma. Recognition of the immune function of the spleen and the risk of overwhelming postsplenectomy infection led to the development of spleen-preserving surgery and nonoperative management. More recently angiographic embolization has been used to try to reduce failure of conservative management and preserve splenic function.Methods: A literature review was performed of the changing treatment of splenic injury over the last century, focusing on whether and how to maintain splenic immune function.Results: Non-operative management continues to be reported as a successful approach in haemodynamically stable patients without other indications for laparotomy, achieving high success rates in both children and adults. Except for haemodynamic instability, reported predictors of failure of conservative treatment should not be seen as absolute contraindications to this approach. Angiographic embolization is generally reported to increase success rates of non-operative management, currently approaching 95 per cent. However, the optimal use of angioembolization is still debated. Splenic immunocompetence after angioembolization remains questionable, although existing studies seem to indicate preserved splenic function.Conclusion: Non-operative management has become the treatment of choice to preserve splenic immune function. Current knowledge suggests that immunization is unnecessary after angiographic embolization for splenic injury. Identifying a diagnostic test of splenic function will be important for future studies. Most importantly, in efforts to preserve splenic function, care must be taken not to jeopardize patients at risk of bleeding who require early surgery and splenectomy.

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Concise Synthesis of the Antidepressive Drug Candidate GSK1360707 by a Highly Enantioselective Gold‐Catalyzed Enyne Cycloisomerization Reaction

Teller

Fürstner

2011

Chemistry A European J

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Out of depression: Indeed, no depressing results are obtained from a gold-catalyzed enyne cycloisomerization controlled by phosphoramidite ligands with TADDOL-related but acyclic backbones (see scheme; Cbz=benzyloxycarbonyl). The “triple-reuptake inhibitor” GSK1360707 was obtained in excellent yield and optical purity, therefore highlighting the relevance of asymmetric gold catalysis for practical applications

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Improved outcome of adult blunt splenic injury: A cohort analysis

Cited by 90 publications

References 23 publications

The role of arterial embolization in blunt splenic injury

The role of arterial embolization in blunt splenic injury

Non-operative management and immune function after splenic injury

Concise Synthesis of the Antidepressive Drug Candidate GSK1360707 by a Highly Enantioselective Gold‐Catalyzed Enyne Cycloisomerization Reaction

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