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Non-operative management for penetrating splenic trauma : how far can we go to save splenic function?

dc.contributor.authorSpijkerman, Royen_ZA
dc.contributor.authorTeuben, Michel Paul Johanen_ZA
dc.contributor.authorHoosain, Fatimaen_ZA
dc.contributor.authorTaylor, Liezel Phyllisen_ZA
dc.contributor.authorHardcastle, Timothy Craigen_ZA
dc.contributor.authorBlokhuis, Taco Johanen_ZA
dc.contributor.authorWarren, Brian Leighen_ZA
dc.contributor.authorLeenen, Luke Petrus Hendrikusen_ZA
dc.date.accessioned2017-07-31T05:53:03Z
dc.date.available2017-07-31T05:53:03Z
dc.date.issued2017-07-25
dc.identifier.citationSpijkerman, R. et al. 2017. Non-operative management for penetrating splenic trauma : how far can we go to save splenic function? World Journal of Emergency Surgery, 12:33, doi:10.1186/s13017-017-0144-3.
dc.identifier.issn1749-7922 (online)
dc.identifier.otherdoi:10.1186/s13017-017-0144-3
dc.identifier.urihttp://hdl.handle.net/10019.1/102028
dc.descriptionCITATION: Spijkerman, R. et al. 2017. Non-operative management for penetrating splenic trauma : how far can we go to save splenic function? World Journal of Emergency Surgery, 12:33, doi:10.1186/s13017-017-0144-3.
dc.descriptionThe original publication is available at https://wjes.biomedcentral.com
dc.description.abstractBackground: Selective non-operative management (NOM) for the treatment of blunt splenic trauma is safe. Currently, the feasibility of selective NOM for penetrating splenic injury (PSI) is unclear. Unfortunately, little is known about the success rate of spleen-preserving surgical procedures. The aim of this study was to investigate the outcome of selective NOM for penetrating splenic injuries. Methods: A dual-centre study is performed in two level-one trauma centres. All identified patients treated for PSI were identified. Patients were grouped based on the treatment they received. Group one consisted of splenectomised patients, the second group included patients treated by a spleen-preserving surgical intervention, and group three included those patients who were treated by NOM. Results: A total of 118 patients with a median age of 27 and a median ISS of 25 (interquartile range (IQR) 16–34) were included. Ninety-six patients required operative intervention, of whom 45 underwent a total splenectomy and 51 underwent spleen-preserving surgical procedures. Furthermore, 22 patients (12 stab wounds and 10 gunshot wounds) were treated by NOM. There were several anticipated significant differences in the baseline encountered. The median hospitalization time was 8 (5–12) days, with no significant differences between the groups. The splenectomy group had significantly more intensive care unit (ICU) days (2(0–6) vs. 0(0–1)) and ventilation days (1(0–3) vs. 0(0–0)) compared to the NOM group. Mortality was only noted in the splenectomy group. Conclusions: Spleen-preserving surgical therapy for PSI is a feasible treatment modality and is not associated with increased mortality. Moreover, a select group of patients can be treated without any surgical intervention at all.
dc.description.urihttps://wjes.biomedcentral.com/articles/10.1186/s13017-017-0144-3
dc.format.extent8 pages
dc.language.isoen
dc.publisherBioMed Central
dc.subjectSpleenen_ZA
dc.subjectSurgery -- Examinations, questions, etc.en_ZA
dc.subjectBlunt splenic traumaen_ZA
dc.subjectGunshot woundsen_ZA
dc.subjectWounds and injuriesen_ZA
dc.subjectStab woundsen_ZA
dc.titleNon-operative management for penetrating splenic trauma : how far can we go to save splenic function?en_ZA
dc.typeArticle
dc.date.updated2017-07-30T03:17:35Z
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


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