Splenectomy for hypersplenism with or without preoperative splenic artery embolisation

Abstract Background Although splenectomy is considered the preferred treatment for hypersplenism, intraoperative blood loss remains a common occurrence. We prospectively compared the perioperative and clinical outcome of splenic artery embolisation (SAE) before open splenectomy (OS) versus OS alone...

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Main Authors: Mohamed M. A. Zaitoun, Mohammad Abd Alkhalik Basha, Ahmed Raafat, Tamer Rushdy, Walid A. Mawla
Format: Article
Language:English
Published: SpringerOpen 2018-09-01
Series:European Radiology Experimental
Subjects:
Online Access:http://link.springer.com/article/10.1186/s41747-018-0053-6
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author Mohamed M. A. Zaitoun
Mohammad Abd Alkhalik Basha
Ahmed Raafat
Tamer Rushdy
Walid A. Mawla
author_facet Mohamed M. A. Zaitoun
Mohammad Abd Alkhalik Basha
Ahmed Raafat
Tamer Rushdy
Walid A. Mawla
author_sort Mohamed M. A. Zaitoun
collection DOAJ
description Abstract Background Although splenectomy is considered the preferred treatment for hypersplenism, intraoperative blood loss remains a common occurrence. We prospectively compared the perioperative and clinical outcome of splenic artery embolisation (SAE) before open splenectomy (OS) versus OS alone in two concurrent patient groups. Methods From January 2016 to January 2018, 50 patients with hypersplenism underwent combined SAE and OS (study group). For comparison, we considered 50 age- and gender-matched case controls undergoing OS without prior SAE during the same period (control group). Perioperative and clinical outcomes were compared between the two groups. Mann–Whitney U test, Student’s t-test, χ2 or Fisher’s exact test were used as appropriate. Results No significant differences were found between the two groups for age, gender and laboratory investigations (p ≥ 0.250). Mortality rate was zero in both groups. No patients of the study group needed perioperative blood transfusion in comparison with patients of the control group (p = 0.003). A significant increase in platelet count was noted in the study group after SAE compared to the control group (p = 0.024). No significant differences between the two groups were observed for operating time, postoperative complications and postoperative stay (p ≥ 0.237). Conclusion We confirm that preoperative SAE in patients who undergo splenectomy for hypersplenism significantly reduces the need for blood transfusion in comparison to splenectomy without prior embolisation. Preoperative SAE is a safe procedure with neither morbidity nor mortality.
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spelling doaj.art-0729a2d23de24559a5e43b5652221d102022-12-22T02:00:45ZengSpringerOpenEuropean Radiology Experimental2509-92802018-09-01211610.1186/s41747-018-0053-6Splenectomy for hypersplenism with or without preoperative splenic artery embolisationMohamed M. A. Zaitoun0Mohammad Abd Alkhalik Basha1Ahmed Raafat2Tamer Rushdy3Walid A. Mawla4Diagnostic Radiology Department, Zagazig UniversityDiagnostic Radiology Department, Zagazig UniversityGeneral Surgery Department, Zagazig UniversityGeneral Surgery Department, Zagazig UniversityGeneral Surgery Department, Zagazig UniversityAbstract Background Although splenectomy is considered the preferred treatment for hypersplenism, intraoperative blood loss remains a common occurrence. We prospectively compared the perioperative and clinical outcome of splenic artery embolisation (SAE) before open splenectomy (OS) versus OS alone in two concurrent patient groups. Methods From January 2016 to January 2018, 50 patients with hypersplenism underwent combined SAE and OS (study group). For comparison, we considered 50 age- and gender-matched case controls undergoing OS without prior SAE during the same period (control group). Perioperative and clinical outcomes were compared between the two groups. Mann–Whitney U test, Student’s t-test, χ2 or Fisher’s exact test were used as appropriate. Results No significant differences were found between the two groups for age, gender and laboratory investigations (p ≥ 0.250). Mortality rate was zero in both groups. No patients of the study group needed perioperative blood transfusion in comparison with patients of the control group (p = 0.003). A significant increase in platelet count was noted in the study group after SAE compared to the control group (p = 0.024). No significant differences between the two groups were observed for operating time, postoperative complications and postoperative stay (p ≥ 0.237). Conclusion We confirm that preoperative SAE in patients who undergo splenectomy for hypersplenism significantly reduces the need for blood transfusion in comparison to splenectomy without prior embolisation. Preoperative SAE is a safe procedure with neither morbidity nor mortality.http://link.springer.com/article/10.1186/s41747-018-0053-6EmbolisationtherapeuticHypersplenismSplenectomySplenic arterySplenomegaly
spellingShingle Mohamed M. A. Zaitoun
Mohammad Abd Alkhalik Basha
Ahmed Raafat
Tamer Rushdy
Walid A. Mawla
Splenectomy for hypersplenism with or without preoperative splenic artery embolisation
European Radiology Experimental
Embolisation
therapeutic
Hypersplenism
Splenectomy
Splenic artery
Splenomegaly
title Splenectomy for hypersplenism with or without preoperative splenic artery embolisation
title_full Splenectomy for hypersplenism with or without preoperative splenic artery embolisation
title_fullStr Splenectomy for hypersplenism with or without preoperative splenic artery embolisation
title_full_unstemmed Splenectomy for hypersplenism with or without preoperative splenic artery embolisation
title_short Splenectomy for hypersplenism with or without preoperative splenic artery embolisation
title_sort splenectomy for hypersplenism with or without preoperative splenic artery embolisation
topic Embolisation
therapeutic
Hypersplenism
Splenectomy
Splenic artery
Splenomegaly
url http://link.springer.com/article/10.1186/s41747-018-0053-6
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AT ahmedraafat splenectomyforhypersplenismwithorwithoutpreoperativesplenicarteryembolisation
AT tamerrushdy splenectomyforhypersplenismwithorwithoutpreoperativesplenicarteryembolisation
AT walidamawla splenectomyforhypersplenismwithorwithoutpreoperativesplenicarteryembolisation