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Laparoscopic surgery for splenic injuries in the era of non-operative management: current status and future perspectives.
- Source :
-
Surgery today [Surg Today] 2021 Jul; Vol. 51 (7), pp. 1075-1084. Date of Electronic Publication: 2020 Nov 16. - Publication Year :
- 2021
-
Abstract
- The spleen is one of the organs most commonly injured by blunt abdominal trauma. It plays an important role in immune response to infections, especially those sustained by encapsulated bacteria. Nonoperative management (NOM), comprising clinical and radiological observation with or without angioembolization, is the treatment of choice for traumatic splenic injury in patients who are hemodynamically stable. However, this strategy carries a risk of failure, especially for high-grade injuries. No clear predictors of failure have been identified, but minimally invasive surgery for splenic injury is gaining popularity. Laparoscopic surgery has been proposed as an alternative to open surgery for hemodynamically stable patients who require surgery, such as after failed NOM. We reviewed research articles on laparoscopic surgery for hemodynamically stable patients with splenic trauma to explore the current knowledge about this topic. After presenting an overview of the treatments for splenic trauma and the immunological function of the spleen, we try to identify the future indications for laparoscopic surgery in the era of NOM.
- Subjects :
- Abdominal Injuries diagnostic imaging
Abdominal Injuries physiopathology
Conservative Treatment methods
Embolization, Therapeutic methods
Female
Hemodynamics
Humans
Laparoscopy trends
Male
Organ Sparing Treatments trends
Spleen diagnostic imaging
Spleen immunology
Splenectomy trends
Trauma Severity Indices
Treatment Failure
Treatment Outcome
Wounds, Nonpenetrating diagnostic imaging
Wounds, Nonpenetrating physiopathology
Abdominal Injuries surgery
Laparoscopy methods
Organ Sparing Treatments methods
Spleen injuries
Splenectomy methods
Wounds, Nonpenetrating surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1436-2813
- Volume :
- 51
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Surgery today
- Publication Type :
- Academic Journal
- Accession number :
- 33196920
- Full Text :
- https://doi.org/10.1007/s00595-020-02177-2