Federica Scarno (Rome / IT), Cristina De Padua (Rome / IT), Immacolata Iannone (Rome / IT), Sara Giovampietro (Rome / IT), Paolo Sapienza (Rome / IT), Gioia Brachini (Rome / IT), Andrea Mingoli (Rome / IT)
Abstract text (incl. references and figure legends)
The gold standard of treatment for blunt splenic trauma in hemodynamically stable or resuscitation responders, in the absence of peritonitis and associated injuries requiring laparotomy is a non-operative management (NOM)1. Splenic artery embolization (SAE) is a valid tool that has greatly increased the successful rate of the NOM2. However, the literature is scarce and no specific information regarding the eventual complications rates related to this procedure are well reported and discussed3. We aimed to study the complication and mortality rates of patients undergoing SAE compared with those who had a standard splenectomy.
In our observational study, between January 2017 and September 2022, we prospectively enrolled 20 consecutive patients (Group 1) who underwent SAE. A control group of 20 patients undergoing splenectomy (Group 2)were matched with those of Group 1 based on a propensity score model. Group 2 patients, operated on from January 2000 and January 2005 (before SAE was introduced in our hospital), were retrieved from our electronic database and hospital charts for additional information if lacking.
Patients who underwent SAE had a higher incidence of complications (50%) than patients who underwent splenectomy (9,1%) (P<0.05). The overall mortality rate was 12,3%, without any significant difference between the two groups (P=NS).
NOM is currently the treatment of choice in patients with splenic trauma, especially in the presence of a medium-low grade injury, but its widespread use might increase the complication rate.
Coccolini, F., et al.Splenic trauma: WSES classification and guidelines for adult and pediatric patients. WJES 12,40(2017). E. Girard, et al. Traumatismes spléniques et pancréatiques; Journal de Chirurgie Viscérale, 153,4, Suppl, Au 2016, Pag46-63. Gill, S., et al.Post-traumatic Splenic Injury Outcomes for Nonoperative and Operative Management: A Systematic Review. World J Surg 45, 2027–2036(2021).Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
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