EVIDENCE BASED MEDICINE IN SPLENIC DISEASES
https://doi.org/10.16931/1995-5464.20161119-124
Abstract
Aim. To systematize information about levels of evidence of studies devoted to surgical pathology of spleen.
Material and Methods. Medical literature in various search systems was analyzed (PubMed search system, The Cochrane Library, academic electronic library eLibrary.ru) using the following keywords: spleen diseases, hyposplenism, hypersplenism, abscess, cyst, echinococcus, parasitic cyst, spleen trauma, spleen rupture, non-surgical treatment. The search results were correlated with ICD-10 according to evidence-based value.
Results. Analysis included 36 publications, including 6 literature overviews with meta-analysis, 12 prospective studies and 18 retrospective studies. Evidence was found that preservation of spleen tissue with arterial blood supply rather than autotransplantation prevents development of postsplenectomy hyposplenism. Conservative tactics in spleen pathology benefits from endovascular blood circulation reduction, radiofrequency ablation and minimally invasive surgery. Vaccination prior to splenectomy and preventive antibiotic therapy after splenectomy reduce the lifetime risk of peracute infection. Non-surgical treatment of damage is a standard maneuver.
Conclusion. Evidence-based medicine of spleen diseases remains rare. Possibly, because of this, the reduced quality of life after splenectomy vs. conservative operations has not been proven for the majority of conditions. Further carefully planned studies will be able to test this hypothesis in relation to surgical spleen pathology.About the Authors
S. E. Grigoriev
Irkutsk Research Center for Surgery and Traumatology; Irkutsk State Medical University, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Grigoriev Sergey Evgenevich – Cand. of Med. Sci., Researcher IRCST, Assistant of the Chair of Hospital Surgery with the Course of Neurosurgery ISMU.
100, Yubileyniy str., Irkutsk, 664049, Phone: +7-902-1-767-106
K. A. Apartsin
Irkutsk Research Center for Surgery and Traumatology; Irkutsk Research Center of Siberian Branch of Russian Academy of Sciences
Russian Federation
Russian Federation
Apartsin Konstantin Anatolevich – Doct. of Med. Sci., Professor, Deputy Director for Research and Medical Work, Head of Laboratory of Clinical Trials IRCST, Head of Department for Medical and Biological Researches and Technologies.
1, Bortsov Revolutsii str., Irkutsk, 664003; 134, Lermontov str., Irkutsk, 664033
Review
For citations:
Grigoriev S.E., Apartsin K.A. EVIDENCE BASED MEDICINE IN SPLENIC DISEASES. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2016;21(1):119-124. (In Russ.) https://doi.org/10.16931/1995-5464.20161119-124
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