Modern approaches in endovascular and endoscopic treatment of isolated splenic injury

Bagatelia ZA, Bedin VV, Grekov DN, et al. . Modern approaches in endovascular and endoscopic treatment of isolated splenic injury. Pirogov Russian Journal of Surgery. 2024;(12):5‑12. (In Russ.)
https://doi.org/10.17116/hirurgia20241215

Подписка 2025-2 (Pirogov Russian Journal of Surgery)

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OBJECTIVE

To analyze treatment outcomes in patients with traumatic spleen injury and improve their management through introduction of modern approaches.

MATERIAL AND METHODS

We retrospectively analyzed treatment outcomes in 126 patients with spleen injury who underwent surgery between 2018 and 2023. Analysis was performed using Excel and Statistica software, as well as Spearman correlation and χ² tests. Differences were significant at p<0.05.

RESULTS

Open interventions were performed in 61 (48.4%) patients, endovascular embolization of splenic artery — in 25 (19.9%) patients. In total, organ-sparing procedures were used in 23 (18.2%) patients. Conservative management was possible in 17 (13.5%) cases. Predictors of early mortality were hemoglobin (r=–0.31; p<0.001), leukocytosis (r=0.12; p=0.01), thrombocytopenia (r=–0.1; p=0.04), spleen injury (r=0.21; p<0.001) and age (r=0.15; p=0.04). Surgery time correlated with hemoglobin level at admission and spleen injury (r=0.21; p=0.001 and r=0.18; p=0.002, respectively). Early endoscopic and endovascular interventions were associated with lower mortality (χ²=5.337; p=0.02 and χ²=3.991; p=0.04).

CONCLUSION

Modern therapeutic and diagnostic strategies, as well as minimally traumatic methods in patients with traumatic spleen damage reduce morbidity and mortality, as well as shorten rehabilitation.

Keywords:

spleen injury

embolization

splenectomy

conservative treatment

Authors:

Bagatelia Z.A.

Russian Medical Academy of Continuous Professional Education;
Botkin Hospital

ORCID: 0000-0001-5699-3695

Bedin V.V.

Russian Medical Academy of Continuous Professional Education;
Botkin Hospital

ORCID: 0000-0001-8441-6561

Grekov D.N.

Russian Medical Academy of Continuous Professional Education;
Botkin Hospital

ORCID: 0000-0001-8391-1210

Kolotilshchikov A.A.

Botkin Hospital

ORCID: 0000-0002-9294-4724

Covantsev S.D.

Botkin Hospital

ORCID: 0000-0001-7236-5699

Eminov M.Z.

Russian Medical Academy of Continuous Professional Education;
Botkin Hospital

ORCID: 0000-0001-7848-2933

Shakirov Kh.A.

Botkin Hospital

ORCID: 0009-0004-4491-6800

Ageeva A.A.

Botkin Hospital

ORCID: 0000-0003-0129-3506

Received:

02.09.2024

Accepted:

10.10.2024

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