SELECTION OF SURGICAL TACTICS FOR CLOSED SPLEEN INJURY, DEPENDING ON THE SEVERITY OF THE CONDITION AT THE TIME OF ADMISSION

• Main Authors: V. V. Maslyakov, V. E. Fedorov, V. Yu. Barsukov, M. A. Shikhmagomedov
• Format: Article
• Language: English
• Published: Penza State University Publishing House 2020-12-01
• Series: Известия высших учебных заведений. Поволжский регион: Медицинские науки
• Subjects: spleen trauma; operative treatment; splenectomy; autolientransplantation; organ-preserving operations; delivery time; selection of surgical treatment

Background. The purpose of the research is to determine the selection of surgical tactics for closed spleen injury, depending on the severity of the condition at the time of admission. Materials and methods. The work carried out a retrospective analysis of the course of the immediate postoperative period of 126 patients with closed spleen injuries who were treated in the emergency surgery unit. Of the total number of patients, males prevailed – 89 (70.6%), women – 37 (29.4%). The study included patients of both sexes with closed abdominal injuries accompanied by concomitant or closed spleen injuries; the age of the patients was 18–55 years old. Patients under 18 and over 55 with brain and spinal cord injuries were not included. Considering that, the main of the leading factors influencing the course of the immediate postoperative period in such patients is the time factor, i.e. the time of delivery to the medical institution from the moment of injury. All patients were divided into two groups: group A - the time of delivery to the medical institution did not exceed one hour from the moment of injury. This group was divided into two subgroups: А1 – closed injuries and А2 – combined injuries. The second group, Group B, included patients whose delivery time exceeded one hour, which were also divided into two subgroups: B1 – closed injuries and B2 – combined injuries. For spleen injuries, three types of operations were used: splenectomy according to the generally accepted technique, autolentransplantation by transplanting a piece of spleen 1.5 cm2 into the tissue of the greater omentum, and organ-preserving operations using a tachocomb. Conclusion. Based on the presented data, it was concluded that the choice of surgical treatment for spleen injury is influenced by the following factors: the nature of the injury, the delivery time from the moment of injury, and the state at the time of admission.