Background: New findings on immunological und haematological functions of the
spleen, the postoperative risks following splenectomy, as well as improved
surgical techniques resulted in an increased interest in organ preservative
surgery after traumatic spleen injury in recent years. Material and Methods:
The data of all patients who un-derwent surgery for traumatic spleen injuries
between 1995 - 2009 were recorded prospectively and analyzed concerning type
of operation, intra-and postoperative complications and the postoperative
course. Results: A total of 214 patients with splenic trauma underwent
surgery. The spleen could be preserved in 80 patients (37,4 %, group 1),
using thermocoagulation, suture, glue sealant, splenorhaphy and partial
spleen resection or combined techniques. 4 of those patients (5 %) required a
revision operation, in which two spleens co-uld be salvaged by application of
glue sealant. Eight of the patients of group 1 could be treated
laparoscopically (10 %). Conclusion: Under consideration of the surgical
segment anatomy of the spleen and the surgical techniques presented, organ
preservation is possible with high success rates, even in patients with
severe splenic damage. In stable patients with minor splenic injury,
laparoscopic or conservative treatment can be considered. Splenectomy should
be reserved for patients with complete shattering of the spleen or instable
patients.
Oesophageal-pericardial fistula: a rare complication of radiation-induced oesophagitis
