Barbuscia M, Praticò C, Pergolizzi F P, Lizio R, Ilaqua A, Minniti C, Sofia L, Gorgone S
Università degli Studi di Messina, Cattedra di Chirurgia dell'Apparato Digerente, Italy.
G Chir. 2007 May;28(5):217-21.
The Authors mention the historical evolution that led to consider the splenectomy as the ideal operation in patients with post-traumatic lesions of the spleen. They linger then on the actual knowledges about the physiopathology of this organ that determined a substantial change of mind to a conservative treatment, when possible. By reporting their experience of the last decade, they weigh up how every therapeutic choice must be consequent to an accurate clinical evaluation that suggests the surgical abdomen exploration in urgency or, on the contrary, the monitoring of the patient. They linger particularly on the validity of the investigation and quantization of organ lesions and of the subsequent hemoperitoneum. The Authors end affirming that an accurate diagnostic evaluation and the subsequent therapy must take place in a specialized Trauma Center that ensures intensive monitoring and, if necessary, a timely operation in these patients.
作者提到了导致将脾切除术视为脾创伤后病变患者理想手术的历史演变。然后,他们详述了关于该器官生理病理学的实际知识,这些知识使得在可能的情况下,人们对保守治疗的观念发生了重大转变。通过报告他们过去十年的经验,他们权衡了每种治疗选择如何必须基于准确的临床评估,该评估表明是紧急进行外科腹部探查,还是相反,对患者进行监测。他们特别详述了器官损伤及随后腹腔积血的检查和量化的有效性。作者最后肯定,准确的诊断评估及后续治疗必须在专门的创伤中心进行,该中心要确保对这些患者进行重症监测,并在必要时及时进行手术。