Application of radiofrequency ablation for splenic preservation

Abstract

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.

Keywords: Abdominal trauma; RFA; Splenectomy; Splenic injury; Splenic preservation.