ABSTRACT
Objective To evalute the indication and clinical application value of microwave abla-tion in spleen-preserving surgery in treament of patients with traumatic rupture.Methods The clinical data of 45 patients with traumatic splenic rupture were retrospectively analyzed.Spleen preserving surgery was feasible by preoperative CT evaluation and intraoperative observation.36 patients received simply mi-crowave ablation,and 9 cases received microwave ablation assisted partial splenectomy.Postoperative com-plications were observed,and the changes of platelet in peripheral blood were detected before and after op-eration in the 3 th,7th,14th day to evaluate the function of spleen.Results 15 patient was complicated with left pleural effusion,1 patient was complicated with splenic fossa fluid associated with infection.Dur-ing the follow-up of at least 2 months,No patients had postoperative bleeding,hemoglobinuria,gastrointes-tinal leak,deep vein thrombosis and pancreatic leak complications,no deaths.Seven days after microwave ablation spleen-preserving surgery,blood platelet count were significantly higher than the levels before the operation (P 0.05).The CT scan and the ultrasonic examina-tion that reviewed after operation in the 30-60th day showed good in spleen imaging in spleen-preserving patients,No patients had portal vein thrombosis.Conclusion Microwave ablation spleen-preserving sur-gery in the treatment of partial traumatic splenic rupture will be a safe and effective operation which could expand the spleen-preserving indication and be used in clinical practice.
ABSTRACT
To summarize the evolution of spleen surgery and prospects the future. The knowledge on the splenic function (anti-infection, cancer and certain blood effects)gradually promotes the reform of spleen surgery in clinical practical, resulting all kinds of spleen-preserving surgery when splenic injury. However,there is still controversy about spleen removal or reservation under the condition of portal hypertension in liver cirrhosis patients, because advantages and disadvantages between these different operations. Laparoscopic splenectomy is a major progress in recent years,the standard operation need to be further explored. Spleen transplantation in the treatment of hemophilia A is one of the characteristics of the spleen surgery in China, and this is the leading position in the world, now we will focus on how to prevent chronic spleen graft dysfunction. To keep the advanced international level, Chinese teams on spleen surgery are still required to deepen the related research and strengthen the academic communication in the future.