Organ-Preserving Surgeries on the Spleen: Evolution of Concepts

Abstract

One of the current trends in modern surgery is the study of the spleen injuries and diseases, in particular, its traumatic ruptures which are a fairly common pathology, being the most prevalent among all injuries of the abdominal organs. The improvement of hemostasis options and the choice of tactics in the surgical treatment of the spleen pathologies are crucial. Few recent decades have been dominated by the idea that splenectomy is the major surgical option for the spleen damage and diseases. Currently, as reported in Russia and globally, surgical tactics implying the use of organ-preserving surgeries in case of the spleen injury are being widely developed and applied.If compared with organ-preserving operations, there are negative changes in the cellular and humoral links of the immunity after splenectomy. A significant number of proposed spleen preserving options are grouped into: conservative treatment, wound tamponades, splenic sutures, segmental resection, ligation of splenic arteries, wound bonding, infrared contact coagulation, autotransplantation of splenic tissue. Currently, surgeons have quite a lot of experimental and clinically tested techniques in their arsenal that allow successfully performing organ-preserving spleen surgery. However, none of them lacks of drawbacks. These drawbacks are quite diverse, ranging from the inability to provide guaranteed reliable hemostasis to technological and economic aspects of the operation, thus, the search for novel organ-preserving techniques remains promising.