Our Summary

This study looked at whether repairing the spleen, rather than removing it (a procedure known as a splenectomy), after a severe injury could reduce the chance of death. The study used data from a large database of trauma cases from January 2013 to December 2019.

The researchers found that of the over 11,000 patients with severe spleen injuries who had surgery, only around 4% had their spleens repaired while the rest had them removed. They then compared the outcomes of 400 patients who had their spleens repaired with 400 who had them removed, matching them for factors like age, sex, type of injury, and severity of injury.

The results showed that the death rate was significantly lower in the group that had their spleens repaired compared to the group that had them removed (6.5% vs 12.8%). Further statistical analysis confirmed this finding.

Therefore, the study concludes that in some severe spleen injury cases, it might be better to try and repair the spleen rather than remove it.

FAQs

  1. What was the main focus of the study about splenectomy?
  2. What were the findings of the study regarding the death rate between patients who had their spleens repaired and removed?
  3. Based on the study, in which cases is it suggested to repair the spleen instead of removing it?

Doctor’s Tip

A doctor might tell a patient who has had a splenectomy to be extra careful about preventing infections, as the spleen plays a key role in the immune system. They might recommend getting vaccinated against certain infections, such as influenza, pneumonia, and meningitis, and to be vigilant about practicing good hygiene and avoiding exposure to sick individuals. Additionally, they may advise the patient to seek medical attention promptly if they develop any signs of infection, such as fever, chills, or persistent cough.

Suitable For

Patients who have suffered severe spleen injuries due to trauma are typically recommended splenectomy. However, based on the findings of this study, it may be beneficial to consider spleen repair as a potential alternative in certain cases to reduce the risk of death. This decision would ultimately depend on the individual patient’s specific circumstances and should be discussed with a healthcare provider.

Timeline

Before splenectomy:

  1. Patient experiences trauma or injury to the spleen.
  2. Patient may undergo diagnostic tests such as ultrasound or CT scan to assess the severity of the injury.
  3. Patient may be monitored closely for signs of internal bleeding or other complications.
  4. Surgery may be recommended if the injury is severe or if there is ongoing bleeding.

After splenectomy:

  1. Patient undergoes surgery to remove the spleen.
  2. Patient may experience pain, discomfort, and fatigue post-surgery.
  3. Patient may need to stay in the hospital for a few days for monitoring and recovery.
  4. Patient may be at increased risk for infections, particularly from encapsulated bacteria, due to the absence of the spleen.
  5. Patient may need to receive vaccinations to prevent infections, particularly against pneumococcus, meningococcus, and Haemophilus influenzae.
  6. Patient may need to take antibiotics or other medications to prevent infections.
  7. Patient may need to undergo regular follow-up appointments with their healthcare provider to monitor their health and address any complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about splenectomy include:

  1. What are the potential risks and benefits of having a splenectomy?
  2. Are there any alternative treatments or procedures that could be considered instead of a splenectomy?
  3. How will my quality of life be affected by having my spleen removed?
  4. Are there any long-term consequences or complications associated with having a splenectomy?
  5. How will having a splenectomy impact my immune system and ability to fight infections?
  6. What is the likelihood of needing a splenectomy in the future if I do not have it done now?
  7. Are there any specific criteria or factors that would make me a better candidate for having my spleen repaired instead of removed?
  8. What is the success rate of spleen repair compared to splenectomy in cases of severe spleen injury?
  9. How long is the recovery process following a splenectomy, and what should I expect during this time?
  10. Are there any lifestyle changes or precautions I should take after having a splenectomy to protect my health and well-being?

Reference

Authors: Jakob DA, Müller M, Kolitsas A, Exadaktylos AK, Demetriades D. Journal: JAMA Netw Open. 2024 Aug 1;7(8):e2425300. doi: 10.1001/jamanetworkopen.2024.25300. PMID: 39093564