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Year : 2020  |  Volume : 26  |  Issue : 2  |  Page : 127-130

Comparison of outcomes between non-operative and operative management of blunt splenic trauma in adults

Department of Surgery, Lancaster University, Lancaster, England, UK

Correspondence Address:
Dr. Joseph McAleer
Department of Surgery, Lancaster University, Lancaster, England
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ksj.ksj_29_20

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Treatment for hemodynamically stable patients is mostly nonoperative observation, with increasing use of splenic angioembolization (SAE). There is a lack of consensus on management plan and use of SAE. In this review, relevant recent literature is analyzed to evaluate the failure rates, complications, mortality, and hospital length of stay for each management method. The analysis of 6299 patients from 9 studies showed that SAE decreased failure rates (1.3%) against nonoperative management (NOM) with 9.8%. There was no significant difference in mortality and hospital length of stay between SAE and NOM. There was increased complications with SAE but it is not enough evidence to draw comparisons between NOM and operative management (OM) due to heterogeneity of studies. SAE decreased need for splenectomies, reduced hospital stay, and complications. OM should be used if the patient is hemodynamically unstable or re-bleeds after NOM. It is imperative that clinicians assess each patient individually and follow a center-based protocol, while keeping in mind, the possible complications from NOM and subsequent interventions. Interventional radiologists will also need to approach SAE with care to prevent technical failures and re-intervention.

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