Abstract
Background
This study aimed to evaluate the effect of fibrin glue in laparoscopic spleen-preserving procedures for traumatic rupture.
Methods
From January 2002 to December 2005, six laparoscopic spleen-preserving procedures were performed for traumatic rupture using fibrin glue. Two of the cases had previous middle and lower abdominal surgery. Survey of the abdominal cavity was performed by inserting two 5- to 12-mm trocars, one 5-mm trocar, and a 30° scope. A complete survey of all the patients was performed.
Results
None of the patients required laparotomy, and no postoperative bleeding occurred. The fibrin sealant achieved immediate hemostasis, and all the patients recovered without further splenic bleeding. The mean postoperative stay was 4.3 days (range, 4–5 days). All the patients were followed up for 3 to 12 months. Postoperative immunoglobulin scanning, ultrasonography, and computed tomography (CT) results were normal.
Conclusions
Laparoscopic management of spleen trauma can be used once a positive diagnosis has been made. It is useful for assessing the degree of splenic injury. A laparoscopic spleen-preserving procedure can be used safely for patients with stable vital data. It is an effective procedure for the evaluation and treatment of hemodynamically stable patients with splenic injuries for whom nonoperative treatment is controversial. The topical application of a fibrin sealant in splenic trauma achieves definitive hemostasis safely, rapidly, and reliably. It also is simple to use in either laparoscopic or open procedures.
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References
Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S, Akazawa K (1999) Quality of life after laparoscopic-assisted Billroth I gastrectomy. Br J Surg 86: 541–544
Berci G, Sackier JM, Paz-Partlow M (1991) Emergency laparoscopy. Am J Surg 161: 332–335
Carbon RT, Baar S, Waldschmdt, Hummer HP, Simon S (2001) Minimal invasive pediatric surgery: development and progress by innovative technology. Klin Pediatr 213: 99–103
Clacy TV, Ramshaw DG, Maxwell JG, et al. (1997) Management outcomes in splenic injury: a state wide trauma center review. Ann Surg 226: 17–24
SH, Shandling B, Simpson JS, et al. (1997) The morbidity and mortality of splenectomy in childhood. Ann Surg 185: 307–310
EL, Neu HC (1981) Postsplenectomy infection. Surg Clin North Am 61: 135–155
C, Vane DW (2000) Changing patterns of treatment for blunt splenic injuries: an 11-year experience in a rural state. J Pediatr Surg 35: 985–988
J (1979) Untersuchung eines Fibrinklebers fur die anwendung. In: Der Chirurgie Peripherer Nerven, Diplomabiet Inst F Botanik, Technische Mikroscopie Organ. Technische Universitat Wien, Rohstofflehre, Vienna
Ra, Filipi CJ, Wetscher G, Neary P, de Meester TR, Perdikis G (1994). Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. Ann Surg 220: 472–481
CGS, Mingoli A, Sgarzini G, Brachini G, Ponzano C, Di Paola M, Modini C (2006) Laparoscopic treatment of blunt splenic injuries: initial experience with 11 patients. Surg Endosc May
N, Mavor E (2000) Laparoscopic splenectomy. Surg Clin North Am 80: 1285–1292
H, Shumacker HB Jr (1952) Splenic studies: I. Susceptibility to infection after splenectomy performed in infancy. Ann Surg 136: 239–242
PJ, Tsiotos GG, Glaser KS, Hinder RA (1999) Laparoscopic splenectomy: evolution and current status. Surg Laparosc Endosc 9: 1–8
RH, Smith RS, Fry WR (1994) Successful laparoscopic splenorrhaphy using absorbable mesh for grade III splenic injury: report of a case. Surg Laparosc Endosc 4: 311–315
G, De Viviee R., Hellberg KD (1981) Clinical experience with fibrin glue in cardiac surgery. J Thorac Cardiovasc Surg 29: 251–256
HB, Nugent P, Reuben BI, et al. (1988) Fibrin glue sealing of polytetrafluororethylene vascular graft anastomoses: comparison with oxidized cellulose. J Vasc Surg 8 : 563–568
HB, Shoemaker WC, Hino ST, et al. (1984) Splenic salvage using biologic glue. Arch Surg 119: 1309–1311
Malangoni MA, Dillon LD, Klamer TW, et al. (1984) Factors influencing the risk of early and late serious infection in adults after splenectomy for trauma. Surgery 96: 775–782
Indoe AH (1932) Delayed hemorrhage following traumatic rupture of the spleen. Br J Surg 20: 249–268
JS, Moore EE, Moore GE, et al. (1982) Alternatives to splenectomy in adults after trauma. Am J Surg 144: 711–716
L, Shapiro SJ (1979) Techniques of splenic conservation. Arch Surg 114: 449–454
CJ, Salky B, Reiner M (2001) Hand-assisted laparoscopic splenectomy for ruptured spleen. Surg Endosc 15:324
N, Champault G, Boutelier P (1995) Laparoscopic splenic salvage in blunt abdominal trauma. Acta Chir Belg 95 (4 suppl): 202–204
A (1993) The laparoscopic treatment of splenic rupture: a case report. Ann Ital Chir 64: 225–228
Scheele J, Gentsch. HH, Matteson E (1984) Splenic repair by fibrin tissue adhesive and collagen fleece. Surgery 95: 6–12
T, Shatney CH (1983) Splenic sequelae after splenectomy for trauma in adults. Am J Surg 145: 667–673
JS Jr, Wegrovitz MA, Delong BS (1992) Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen. J Trauma 36: 385–389
AC, Perry JF (1982) Splenic preservation following splenic trauma. J Trauma 22: 496–501
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An erratum to this article can be found at http://dx.doi.org/10.1007/s00464-007-9468-5
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Olmi, S., Scaini, A., Erba, L. et al. Use of fibrin glue (Tissucol) as a hemostatic in laparoscopic conservative treatment of spleen trauma. Surg Endosc 21, 2051–2054 (2007). https://doi.org/10.1007/s00464-007-9288-7
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DOI: https://doi.org/10.1007/s00464-007-9288-7