[A new technique of splenic preservation: extraperitoneal transposition of the traumatized spleen].

Abstract

The lifelong risk of overwhelming infection after splenectomy is well recognized. Although children are at greater risk, adults are clearly vulnerable. This is an incentive to safely preserve the spleen in splenic injuries. Nonoperative management and use of different surgical techniques and synthetic materials to stop bleeding have been experienced and reported. They have the major advantage of spleen mass preservation and prevention of splenectomy complications: but also some disadvantages, for instance: prolonged hospital stay and subdiaphragmatic collection or delayed spleen rupture. This has prompted us for splenic salvation without any attempt to stop bleeding by transposition of spleen into an extraperitoneal cavity created surgically. During a 4 year period (from the end of 1989 to the fall of 1993) ten trauma patients were treated with this original technique. All of these patients had a definitive indication for emergency laparotomy. The procedure was successful in all patients without any unexpected complication.