Jung F, Chazelet C, Sibilly A, Piemont Y, Aprahamian M
J Chir (Paris). 1986 Feb;123(2):91-5.
Conservative surgery to spleen is an ancient concept brought up-to date by improved knowledge of its fundamental roles in immunity and anti-bacterial defences. Suture of spleen and partial splenectomy ensure the best possible functional results but have technical limitations resulting frequently in splenectomy to provide hemostasis. Data from clinical and experimental studies and reports in the literature have demonstrated that autotransplantation of spleen is a simple, safe and effective method for preventing the true dangers of asplenia. Optimal results from autotransplantation of spleen are obtained when the injured organ is broken into small fragments which are then implanted into small spaces fashioned in the greater omentum. Clinical and biological tests to evaluate functional value of these transplants have shown that results approach those of a normal or sutured spleen. It is concluded that this procedure, which completes other conservative methods of splenic surgery, should definitely exclude hemostasis splenectomy from therapy of injuries to spleen.
脾脏保守性手术是一个古老的概念,随着对其在免疫和抗菌防御中基本作用的深入了解而与时俱进。脾脏缝合术和部分脾切除术可确保获得最佳功能效果,但存在技术局限性,常导致为实现止血而进行脾切除术。临床和实验研究数据以及文献报道表明,脾脏自体移植是预防无脾症真正危险的一种简单、安全且有效的方法。当受损器官被破碎成小碎片,然后植入大网膜中形成的小空间时,可获得脾脏自体移植的最佳效果。评估这些移植功能价值的临床和生物学测试表明,结果接近正常或缝合脾脏的结果。得出的结论是,这种完善了脾脏手术其他保守方法的手术,在脾脏损伤治疗中应明确排除用于止血的脾切除术。