Application of radiofrequency ablation for splenic preservation

作者：Wu Yakun; Wan Lili; Li Peizhi; Zhang Yinglin; Li Min; Gong Jianping; Zhang Wei^*

来源：Journal of Surgical Research, 2015, 193(2): 781-787.

DOI：10.1016/j.jss.2014.07.031

• Abdominal trauma
• Splenic injury
• Splenic preservation
• Splenectomy
• RFA

Background: Traditional splenic preservation surgery involves considerable difficulties, high risks, and numerous postoperative complications. In this study, we applied radiofrequency ablation (RFA) to splenic preservation and explored its clinical value.
Methods: The clinical data of 129 patients with traumatic splenic rupture who received surgery in our hospital from September 2008-June 2013 were retrospectively analyzed. According to the operation methods, these patients were divided into three groups: 35 patients received splenic preservation surgery with RFA-assisted technique (RFA + suture repair group), 78 patients received splenic preservation surgery without RFA (traditional operation group), and 46 patients received splenectomy (splenectomy group). Preoperative, intraoperative, and postoperative-related parameters of the former two groups were compared. The postoperative complications and immunologic parameters of patients with preserved spleens were compared with those of patients who underwent splenectomy.
Result: In the RFA + suture repair group, 34 cases successfully underwent splenic preservation surgery. Meanwhile, 49 cases successfully underwent spleen preservation surgery in the traditional operation group. RFA + suture repair group had shorter mean operation time (79 +/- 22 versus 119 +/- 26 min, P < 0.05), less bleeding during surgery (115 +/- 67 versus 235 +/- 155 mL, P < 0.05), and less intraoperative transfusion (14% versus 36%, P < 0.05). The postoperative bleeding and hospital-stay duration were remarkably lower than those in the traditional operation group (100 +/- 52 versus 219 +/- 93 mL and 7.1 +/- 1.4 d versus 11.7 +/- 2.8 d, respectively, P < 0.05). The spleen-preserving patients showed better results than the splenectomy group did for some parameters related to complications and immunology.
Conclusions: Compared with traditional splenic preservation, RFA is simple and feasible, and it can greatly benefit the spleen preservation operation.

• 出版日期2015-2
• 单位重庆医科大学