Management of Traumatic Splenic Rupture in Adults: A Single Center's Experience in Mainland China

摘要

Background/Aims: We evaluated the effectiveness of various therapies to treat the traumatic splenic rupture by using data from our single center. Methodology: From July 2008 to Jan 2014, 125 patients who were diagnosis spleen rupture without other organ injury were included into our present study. We divided these patients into two groups according to the managements of the splenic rupture: the operative management (OM) group (48 patients) and the non-operative management (NOM) group (77 patients). We compared the baseline characteristics and long-term outcomes of two groups. The OM group was divided into three sub-groups according to the different operative methods: the total splenectomy group, partial splenectomy group and radiofrequency ablation (RFA) group. Results: Splenic injuries were most commonly observed in abdominal trauma: traffic accidents (49 cases), fall from height (36 cases), strike (22 cases), assaults (11 cases), and sports (7 cases). Of the patients included in our study, 48 patients accepted OM, and 77 patients accepted NOM. The baseline characteristics, including age, gender, BMI, and underlying diseases, were comparable between the two groups. However, the OM group patients exhibited more severe splenic rupture according to the AAST grade (P=0.000). The three subgroups in the OM group (total splenectomies group (26 cases), partial splenectomy (12 patients), RFA-assisted spleen-preserving surgery (10 patients) exhibited no significant differences with respect to intraoperative data or postoperative recovery. The length of hospital stay in the NOM group was significantly longer than that in the OM group (6.8±1.4 VS 3.4±0.8, P=0.000), but the OM and NOM patients reported comparable quality of life according to the SF-36 scale. Conclusion: In conclusion, the outcomes of operative management for splenic rupture were comparable, and the OM and the NOM patients exhibited a similar quality of life after splenic rupture, although longer hospital stays were observed in the NOM group.