|
|
|
|
|
The role of laparoscopy in the management of traumatic splenic injury |
Chen Xiang-yu, Xie Bin, Deng Wen-jun, Xie Bai-fa, Zhou Chun-rong, Ma Jian, Zou Long, Liu Ming-hua |
Emergency and Trauma Center, the First Affiliated Hospital of Army Medical University, Chongqing 400038, China |
|
|
Abstract Objective To evaluate the role and limitation of laparoscopy in the management of traumatic splenic injury. Methods 85 cases, who were admitted in Emergency and Trauma Center of Southwest Hospital from Apr. 2007 to Jan. 2018, with traumatic splenic injury were reviewed. Results 47 cases were treated by laparotomy and 38 cases by laparoscopy. Patients who underwent laparoscopy experienced shorter duration of mechanical ventilation, ICU and hospital stay, shorter intestinal function recovery time, and less complaints for postoperative pain than laparotomy group. The spleen reservation rate of laparoscopic group was higher than laparotomy group. The mean operative time of laparoscopic group was longer than laparotomy group. There were no deaths and unplanned secondary operations due to splenic surgery in both groups. There were no differences of intraoperative blood loss and incidences of perioperative complications between two groups. Conclusion Laparoscopy is minimal traumatic and safe surgical procedure for traumatic splenic injury, leads to quicker recovery, fewer complications, and higher spleen reservation rate and can effectively shorten the ICU and hospital stay and so on. However, the employment of laparoscopy for traumatic splenic injury should also be restricted. In tough cases laparotomy should be employed without any hesitation, to avoid serious complications.
|
|
Corresponding Authors:
Liu Ming-hua, E-mail: mhliu4cq@aliyun.com
|
|
|
|
[1]Khubutiya MS, Yartsev PA, Guliaev AA, et al. Laparoscopy in blunt and penetrating abdominal trauma[J]. Surg Laparosc Endosc Percutan Tech, 2013, 23(6):507-512.
[2]Yorkgitis BK. Primary care of the blunt splenic injured adult[J]. Am J Med, 2017, 130(3):365.
[3]Hady HR, uba M, My liwiec P, Trochimowicz L, et al. Surgicalmanagementin parenchymatous organ injuries due to blunt and penetrating abdominal traumas--the authors′ experience[J]. Adv Clin Exp Med, 2012, 21(2):193-200.
[4]Ermolov AS, Tlibekova MA, Yartsev PA, et al. Laparoscopic Splenectomy in Patients with Spleen Injuries[J]. Surg Laparosc Endosc Percutan Tech, 2015, 25(6):483-486.
[5]Berg RJ, Inaba K, Okoye O, et al. The contemporary management of penetrating splenic injury[J]. Injury, 2014, 45(9):1394-1400.
[6]Stassen NA, Bhullar I, Cheng JD, et al. Selective nonoperative management of blunt splenic injury: an eastern association for the surgery of trauma practice management guideline[J]. J Trauma Acute Care Surg, 2012, 73(5 Suppl 4):S294-300.
[7]Cirocchi R, Boselli C, Corsi A, et al. Is non-operative management safe and effective for all splenic blunt trauma A systematic review[J]. Crit Care, 2013, 17(5):R185.
[8]郑民华.中国腹腔镜外科的现状与进展[J].中华腔镜外科杂志(电子版), 2010, 3(1):1-6.
[9]Uranues S, Alimoglu O. Laparoscopic surgery of the splen[J]. Surg Clin North Am, 2005, 85(1):75-90.
[10]Krikri A, Alexopoulos V, Zoumakis E, et al. Laparoscopic vs. open abdominal surgery in male pigs: marked differences in cortisol and catecholamine response depending on the size of surgical incision[J]. Hormones (Athens), 2013, 12(2):283-291.
[11]Shan CX, Ni C, Qiu M, et al. Is laparoscopy equal to laparotomy in detecting and treating small bowel injuries in a porcine model[J]. World J Gastroenterol, 2012, 18(46): 6850-6855.
[12]Zafar SN, Onwugbufor MT, Hughes K.Laparoscopic surgery for trauma: the realm of therapeutic management[J]. Am J Surg, 2015, 209(4):627-632.
[13]Arbuthnot M, Onwubiko C, Mooney D. The lost art of the splenorrhaphy[J]. J Pediatr Surg, 2016, 51(11):1881-1884. |
|
|
|