Laparoscopic splenectomy as a definitive management option for high-grade traumatic splenic injury when non operative management is not feasible or failed: a 5-year experience from a level one trauma center with minimally invasive surgery expertise

• DOI: 10.1007/s13304-021-01045-z
• Publication Date: 2021-04-10T12:02:39Z
• Authors: Arianna Birindelli; Matthew Martin; Mansoor Khan; Gaetano Gallo; Edoardo Segalini; Alice Gori; Amy Yetasook; Mauro Podda; Antonio Giuliani; Gregorio Tugnoli; Robert Lim; ; Michael Cripps; Paschalis Gavriil...; Antonio Affinita; Carlo Coniglio; Fausto Catena; Antonio Tarasconi; Belinda De Simone; Nicola De’ Angelis; Luca Ansaloni; Dario Tartaglia; Federico Coccolini; Massimo Chiarugi; Ferdinando Agresta; Gianluca Baiocchi; Gabriele Sganga; Isidoro Di Carlo; Francesco Pata; Marcelo Augusto F...; Daniel Souza Lima; Gustavo Pereira F...; Bruno Monteiro Pe...; Paolo Millo; Massimo Sartelli; Valeria Tonini; Maurizio Cervellera; Pierpaolo Sileri; Giovanni Del Vecchio; Pierluigi Marini; Salomone Di Saverio
• Keywords: Trauma Center

Abstract Technique, indications and outcomes of laparoscopic splenectomy in stable trauma patients have not been well described yet. All hemodynamically non-compromised abdominal who underwent from 1/2013 to 12/2017 at our Level 1 center were included. Demographic clinical data collected analysed with per-protocol an intention-to-treat comparison between open vs groups. 49 splenectomies performed (16 laparoscopic, 33 open). Among the group, 81% successfully completed laparoscopically. Laparoscopy was associated a higher incidence concomitant surgical procedures ( p 0.016), longer operative times, but significantly faster return bowel function oral diet without reoperations. No significant differences demonstrated morbidity, mortality, length stay, or long-term complications, although had lower site infection (0 21%).The isolated splenic injury sub-analysis included 25 splenectomies,76% (19) 24% (6) confirmed reduction post-operative morbidity (40 57%), blood transfusion 48%), ICU admission (20 57%) overall LOS (7 9 days) group. Laparoscopic is safe effective technique for may represent advantageous alternative terms recovery morbidity.