Evaluation of splenic preserving surgical procedures in management of traumatic splenic injuries

Abstract

Sixty five cases of splenic injuries were studied to assess feasibility of splenic operative preserving techniques. Splenic salvage was feasible for 38.5% of total number of cases, where splenorrhaphy with interrupted sutures augmented by Surgicel was performed in 31% of cases and partial splenectomy was performed in 7.5%. The most frequent cause of splenic injuries was motor vehicle accident, followed by firearm injuries, then stabs for the abdomen and finally falls from a height. The injury severity score (ISS) in the splenectomy group (group A) was significantly higher than the salvage group (group B). Associated injuries were more abundant in group A. Preoperative hemoglobin was used in our study as one of the predictors for the feasibility of splenic salvage, and there was a significant decrease in the splenectomy patients. The hospital stay & ICU admissions significantly increased in the total splenectomy group due to associated injuries. There were no reoperations for bleeding in the salvage group. Complications were more common with the total splenectomy group, also it was noticed that there wasn’t any hemorrhagic, severe septic or anatomical complication in the salvage group. Mortalities occurred in four cases in the total splenectomy group. The operative time showed significant increase in the salvage group while the intraoperative blood transfused shows no significant changes between both groups.