Laparoscopic Splenectomy in Patients With Spleen Injuries

Ermolov, A S; Tlibekova, Margarita A.; Yartsev, P. A.; Гуляев, А. А.; Rogal, M. M.; Samsonov, V. T.; Левитский, В. Д.; Черныш, О А

doi:10.1097/sle.0000000000000207

Cited by 16 publications

(13 citation statements)

References 38 publications

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“…According to the AAST criteria, our overall splenic grade approached IV. 14 Ermolov et al 12 reported a large study in 2015, comparing 23 laparoscopic splenectomies and 19 open splenectomies for grade III lacerations. The results showed longer operating times in the laparoscopic group, but no difference in complications or mortality, which is similar to the current investigation.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Splenectomy in Hemodynamically Stable Blunt Trauma

Huang¹,

Chance²,

Hileman³

et al. 2017

JSLS

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Background and Objectives:No criteria define indications for laparoscopic splenectomy in trauma. This investigation compared characteristics of trauma patients and outcomes between laparoscopic and open splenectomies.Methods:Patients were identified retrospectively by using ICD-9 codes. Included patients were 18 or older, with a blunt splenic injury from January 1, 2011, through December 31, 2014, and required splenectomy. Excluded patients had penetrating trauma, successful nonoperative management, or successful embolization. Variables included demographics, presenting characteristics, injury severity scores, abdominal abbreviated injury scores, splenic injury grade, surgical indication and approach (open or laparoscopic), surgery length, intra-operative blood loss, transfusions, length of stay, complications, mortality, and discharge disposition.Results:Forty-one patients underwent open splenectomy, and 11 underwent laparoscopic splenectomy. The mean age was 48.7 years, and men comprised the sample majority (36/52). The groups were well matched for age, abdominal injury scores, and admission vital signs. The open group had a significantly lower level of consciousness and more acidosis compared with the laparoscopic group. Most laparoscopic splenectomies were performed after failed nonoperative management or embolization. The indications for open splenectomy were a positive focused assessment with sonography for trauma and computed tomography results. Laparoscopic patients had significantly longer times between presentation and surgery and longer operations, but had significantly less blood loss and fewer transfusions compared with the open group. There were no differences in mortality, length of stay, complications, or discharge dispositions.Conclusion:Laparoscopic splenectomy is useful in patients with blunt trauma in whom conservative management produced no improvement and who do not have other injuries to preclude laparoscopy.

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Section: Discussionmentioning

confidence: 99%

“…7–10 For more than 20 years, laparoscopic splenectomies in trauma patients have been described mostly in case reports or case series. 4–6,11–13 However, the laparoscopic approach requires further investigation, because its role in trauma remains poorly defined.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Splenectomy in Hemodynamically Stable Blunt Trauma

Huang¹,

Chance²,

Hileman³

et al. 2017

JSLS

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“…1 demonstrate that laparoscopic splenectomy with selective ligation of hilar vessels is feasible and safe in selected patients with high-grade splenic trauma. Laparoscopy has several advantages over an open approach, such as more rapid postoperative recovery, reduced pain, wound and chest infections and a lower incidence of incisional hernias [2][3][4]. The reduced rate of chest infection associated with laparoscopic procedures is particularly important in trauma patients with lung contusions and rib fractures.…”

Section: Supporting Informationmentioning

confidence: 99%

Laparoscopic splenectomy with selective intracorporeal ligation of splenic hilar vessels for high‐grade splenic injury – a video vignette

et al. 2018

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A 59-year-old hemodynamically stable female is admitted following a domestic fall with blunt left sided thoraco-abdominal trauma. She lived alone and had multiple comorbidities including hepatitis C virus positive splenomegaly, chronic psychosis with a history of opioid and alcohol abuse. A CT-scan of thorax and abdomen with IV contrast showed left lung contusions and multiple left rib fractures with no pneumothorax, a high grade splenic injury with intra-parenchymal hematoma and small arterial blushes in the superior splenic pole associated with celiac trunk stenosis, mild intra-abdominal free fluid and grade II injury to the left kidney. This article is protected by copyright. All rights reserved.

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“…For grades IV and V, non-operative management is associated with complications and higher failure rate [10]. The only steady condition mentioned in the literature in the choice of laparoscopic splenectomy for spleen lesions is that the patient should be hemodynamically stable [1,3,4,6,11]. On the other hand, asplenia increases the risk of serious infections and thromboembolic accidents and favors the progression of the atherosclerosis and the pulmonary hypertension [12] which has led surgeons from everywhere to try to preserve the spleen.…”

Section: Discussionmentioning

confidence: 99%

“…The management of the spleen trauma has evolved considerably however from exploratory laparatomy with splenectomy, to nonoperative management, partial splenectomy and laparoscopic splenectomy. There is more and more reporting of the minimally invasive approach to spleen trauma and although laparoscopic splenectomy in trauma requires a longer time of surgery [3], patients benefit from all the advantages of this procedure. Splenomegaly was considered the open surgery privilege but with the evolution of surgeons' experience and that of the equipment, the indication of laparoscopic splenectomy expanded to splenomegaly of up to 1000 g or maximum size of 15 cm [4].…”

Section: Introductionmentioning

confidence: 99%

Splenectomy in Special Cases

Leşe¹

2019

Surg Res

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Background: The indications of splenectomy and its ways to perform are today well coded. Recognizing the risks of fulminant infections and discoveries in the field of surgical techniques, in anesthesia but also in hematology and oncology, have reduced morbidity and mortality rate after total or partial splenectomy, regardless of the disease for which it was indicated. Case Presentation: The article aims to present two cases of splenectomy performed in special conditions: spleen lesion operated laparoscopically in child and splenectomy in case of extreme splenomegaly, with the revision of the specialized literature. Conclusion: Laparoscopic splenomectomy is feasible in case of splenic trauma, provided that the condition of the patient is stable and a well-trained team and high-performance medical equipment are available. In the case of splenomegaly, the adhesions and the branching of the spleen vessels make the difference between easy and difficult splenectomy.

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Laparoscopic Splenectomy in Patients With Spleen Injuries

Cited by 16 publications

References 38 publications

Laparoscopic Splenectomy in Hemodynamically Stable Blunt Trauma

Laparoscopic Splenectomy in Hemodynamically Stable Blunt Trauma

Laparoscopic splenectomy with selective intracorporeal ligation of splenic hilar vessels for high‐grade splenic injury – a video vignette

Splenectomy in Special Cases

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