The possibilities of endovascular, laparoscopic and hybrid surgeries in patients with blunt spleen injury

The OBJECTIVE was to improve the treatment outcomes for patients with splenic trauma using minimally invasive technologies.METHODS AND MATERIALS. The study included 22 patients with splenic trauma who underwent surgery from 2019 to 2025 inc. Men were 17 (77.3 %) and women – 5 (22.7 %). The mean age was 37.4±5.1 years. The median age was 35 years (20 – 71). To assess the effectiveness of two treatment methods (videolaparoscopic splenectomy and X-ray endovascular embolization), the patients were divided into two equal groups (11 patients in each). There were no statistically significant differences in gender, age, or severity of injury in both groups. The Statistica 10.0 package was used for data analysis.RESULTS. Early postoperative complications were detected in 5 patients: in 4 patients (36.4 %) after videolaparoscopic splenectomy and in 1 patient (9.1 %) after angioembolization (p≥0.05). The mean length of hospital stay was 19.1±21.5 in the splenectomy group versus 10.9±16.4 after angioembolization (p≥0.05). There were no deaths in the splenectomy group. In the angioembolization group, mortality rate was 1 (9.1 %).CONCLUSION. Any minimally invasive intervention, including hybrid, with low-trauma access has better results in injured patients than operations with laparotomy access. The hospitalization duration in most cases depends on the presence of combined injuries and comorbidities in the patients, rather than on the type of minimally invasive surgical intervention performed. No significant difference was found between the immediate treatment outcomes in the group receiving angioembolization and the group undergoing videolaparoscopic splenectomy. Further research is required, along with an analysis of long-term outcomes, including an assessment of patients’ quality of life both after splenectomy and after blood flow reducing in the preserved organ.