Postoperative infection risk after splenectomy: A prospective cohort study

Barmparas, Galinos; Lamb, Alexander W.; Lee, Debora; Nguyen, Brandon; Eng, J.; Bloom, Matthew B.; Ley, Eric J.

doi:10.1016/j.ijsu.2015.03.007

Cited by 36 publications

(36 citation statements)

References 24 publications

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“…The impact of splenectomy on distant organ injury appears to be organ dependent. While splenectomy is an independent risk factor of postoperative complications including early postsurgical infections and lung injury, it appears to have a protective effect on ischaemic damage to the brain and liver [36][37][38][39]. In support of our findings, splenectomy has been shown to have a significant beneficial effect in an animal model of kidney ischaemia-reperfusion injury [40].…”

Section: Discussionsupporting

confidence: 77%

Identification of risk factors associated with postoperative acute kidney injury after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a retrospective study

Cata

Zavala

Meter

et al. 2017

International Journal of Hyperthermia

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Section: Discussionsupporting

confidence: 77%

Identification of risk factors associated with postoperative acute kidney injury after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a retrospective study

Cata

Zavala

Meter

et al. 2017

International Journal of Hyperthermia

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“…In a comparative study patients with splenectomy vs. patients with other abdominal surgery had 49 % vs. 29 % of POM respectively (OR 2.7 [95 % CI 1.3, 5.6]); but on a subgroup analysis, there were no differences between traumatic and elective splenectomy with regards to overall infectious complications (50 % vs. 46 %, p = 0.84) (Evidence level type 4) (Barmparas et al, 2015). Surgical wound infection is up to 7.0 %.…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-nine articles in extensive were discarded for failing to meet the eligibility criteria. Finally, the population in study consisted of 35 articles, 3 of evidence level type 3a (Renzulli et al, 2009;He et al, 2014;Piccolo et al, 2014), 32 of evidence level type 4 (Bagrodia et al, 2014;Barmparas et al, 2015;Bracale et al, 2013;Cassar & Munro, 2009;Coon, 1990;Chung et al, 2011;Davies et al, 2014;Eaton et al, 2000;Eber et al, 1999;Edgren et al, 2014;Flum et al, 2001;Geraci et al, 2014;Gómez Alonso et al, 2001;Ha & Minchin, 2009;Harbrecht et al, 2008;Holubar et al, 2009;Kamath et al, 2009;Malek et al, 2007;Masoomi et al, 2012;McIntyre et al, 2005;Merchea et al, 2012;Nikolaev et al, 1990;Ong et al, 1991;Paredes et al, 2013;Rogers et al, 1980;Singla, et al, 2012;Tan et al, 2011;Urschel, 1993;Wang et al, 2011;Yong et al, 2010; and 1 of evidence level type 5 (American Society for Metabolic & Bariatric Surgery, 2012).…”

Section: Resultsmentioning

confidence: 99%

Incidental Splenic Injury and Splenectomy: An Overview Based on Available Evidence

Manterola

Otzen

2016

Int. J. Morphol.

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SUMMARY:Splenectomy indications are hematologic disease, traumatic damage and iatrogenic injury. The aim of this study was to present an evidence-based overview of some clinical aspects of interest related with iatrogenic splenic injury and subsequent splenectomy. An overview of the available evidence was conducted. Articles that evaluated clinical aspects of interest related with iatrogenic splenic injury and subsequent splenectomy, without language limits, publication date and designs. BVS, PubMed, SciELO and TRIP databases were reviewed. Evaluated variables were: Frequency and etiology of surgical spleen injuries, treatment options, frequency of splenectomy, associated postoperative morbidity (POM) and mortality, recommendation for splenectomy. Classification of the available evidence was made using the classification proposed by Oxford Centre of Evidence-based Medicine. 1144 records were obtained. 1109 were discarded for not meeting eligibility criteria, or were not relevant for the purpose of this research. Finally, the study consisted of 35 articles, 3 of evidence level type 3a, 31 of evidence level type 4 and 1 of evidence level type 5. Splenectomy is a complication of common abdominal procedures, prevalence and incidence of iatrogenic splenic injury is underestimated because of lack of information, there is evidence of risk factors of surgical spleen injuries, the etiology of surgical spleen injuries are bariatric, esophagogastric, antireflux, colorectal, abdominal vascular and urological procedures. POM in patients undergoing splenectomy is more frequent in emergency splenectomy secondary to trauma. There was no significant risk reduction of infectious complications after implementation of routine vaccination. Available evidence is based on few and heterogeneous articles, which make a meaningful conclusions difficult. Studies with better evidence levels, methodological quality and population size are needed for conclusions and recommendations.

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“…Intra-abdominal abscesses can also occur due to injury to the stomach, pancreas or intestine during splenectomy, but the incidence reported is less than 1 percent and the presentation is usually early during the post-operative period[8,9]. Splenectomy performed for splenic abscess can present with intra-abdominal abscess due to contamination of peritoneal cavity and post-splenectomy immunosuppressed state[10].…”

Section: Discussionmentioning

confidence: 99%

Intra-abdominal abscess and intractable sinus - a rare late complication after splenectomy

Shrestha

Hampton

2017

WJCC

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Intra-abdominal abscess and an intractable abdominal wall sinus forty years after splenectomy is rare, which has not been described previously in the surgical literature. We report the management of a patient who had presented with an intractable sinus on his left hypochondrium forty years after having undergone splenectomy and cholecystectomy, which persisted for more than two years despite repeated surgery and courses of antibiotics and compromised quality of life significantly from pain. A sinogram and computerised tomographic scan followed by exploration and laying open of the sinus delivered multiple silk sutures used for ligation of splenic pedicle, led to complete resolution of the sinus. It is important to avoid using non-absorbable silk sutures during splenectomy when splenectomy is undertaken in a contaminated field. Appropriate imaging and exploration is mandatory for its resolution.

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Postoperative infection risk after splenectomy: A prospective cohort study

Abstract: Splenectomy increases the risk for post-operative infectious complications. Further studies identifying strategies to decrease the associated morbidity are necessary.

Cited by 36 publications

References 24 publications

Identification of risk factors associated with postoperative acute kidney injury after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a retrospective study

Identification of risk factors associated with postoperative acute kidney injury after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a retrospective study

Incidental Splenic Injury and Splenectomy: An Overview Based on Available Evidence

Intra-abdominal abscess and intractable sinus - a rare late complication after splenectomy

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