Scientific paperAlternatives to splenectomy in adults after trauma: Repair, partial resection, and reimplantation of splenic tissue☆
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Surgical Management of Solid Organ Injuries
2017, Surgical Clinics of North AmericaCitation Excerpt :Management of blunt splenic trauma (BST) has substantially evolved over the past century. More than 100 years ago, evaluation of postmortem findings led Bilroth to suggest that the injured spleen has the ability of self-healing, and may be observed with NOM.48–59 The landmark Eastern Association for the Surgery of Trauma (EAST) trial in 2000 established the failure rates based on grade of injury for BST with little to no intervention.60
Spleen injuries in Spain: At what point are we?
2013, Cirugia EspanolaAge does not affect outcomes of nonoperative management of blunt splenic trauma
2012, Journal of the American College of SurgeonsCitation Excerpt :The description of overwhelming postsplenectomy sepsis in 1952 led surgeons to look for alternative management strategies for splenic preservation.15 Although adult surgeons developed splenic salvage techniques such as splenorrhaphy and partial splenectomy to address this challenge, pediatric surgeons provided both clinical and animal model evidence to support NOM as a safe alternative.16-18 Adult trauma surgeons, however, were still slow to adopt NOM techniques, given concerns about missing other concomitant intra-abdominal injuries and early reports of 30% to 70% FNOM rate.19,20
Controversies in the management of splenic trauma
2012, InjuryCitation Excerpt :The main focus of treatment was hemorrhage control, and splenectomy was the treatment for virtually all splenic injuries, regardless of how minor. In the 1980s, increased awareness of the immunologic importance of the spleen, prompted efforts towards splenic salvage and led to the development of techniques such as splenorraphy and partial resection [15,21]. Expanding on the groundbreaking approaches of paediatric trauma surgeons, it became clear that non-operative management of splenic injuries was also a therapeutic option [6,14].
Bacterial clearance after total splenectomy and splenic autotransplantation in rats
2002, Applied Radiation and IsotopesInjury to the spleen
2001, Current Problems in SurgeryCitation Excerpt :Moore and colleagues41 reported the case of a patient who died of OPSI after splenectomy plus autotransplantation, with a postoperative radionuclide scan that showed splenic uptake. Other studies of patients who underwent splenic autotransplantation after splenectomy have demonstrated normalization of immunoglobulin and complement factor (C3) levels, disappearance of Howell-Jolly bodies (which suggests normal hematologic function), and the presence of reticuloendothelial function, as shown by the appearance of splenic tissue on technetium sulfur colloid scans.86,93,164 In an important study, Traub and colleagues63 compared various treatment options (including splenorrhaphy, partial splenectomy, and total splenectomy with or without splenic autotransplantation) in 51 patients with spleen injury after abdominal trauma.
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Presented at the 34th Annual Meeting of the Southwestern Surgical Congress, April 29, 1982, Coronado, California, April 26–29, 1982.
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From the Departments of Surgery, University of Colorado Health Sciences Center and Denver General Hospital, Denver, Colorado.