Evolution in the management of splenic trauma. Retrospective study in children.
Autor(a) principal: | |
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Data de Publicação: | 1998 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2347 |
Resumo: | The treatment of blunt splenic lesions had changed in the last years with an increasing trend to conservative management. In the absence of national surveys, this paper is aimed to evaluate the results of this therapeutic approach in a group of Portuguese children.Patients with blunt splenic lesions, admitted over a period of 7 years, (n = 54) were retrospectively analysed. A group submitted to surgical treatment 'ab initio' (group A, from 1990 to 1992 incl.) was compared with a group managed by a conservative approach (group B, from 1993 to 1996 inclusive). Age, sex, associated lesions, treatment, need of a blood transfusion and length of hospital stay were studied.The frequency of splenic lesions was relatively stable (6 to 10 years) in both periods. Group A (n = 24) was similar to group B (n = 30) regarding gender and age. In group A, 23 (97%) splenectomies were performed. In group B, only six (20%) children underwent laparotomy and 4 (13%) of them were submitted to splenectomy (A vs. B, p < 0.001). The need of a blood transfusion was similar in the two groups and so were the associated lesions. The great majority of transfused children presented associated lesions (10/11, 91%). In group B, associated lesions did not significantly alter the effectiveness of the conservative treatment. Hospital stay was significantly longer in group B (B vs. A: 12.5 +/- 2.5 vs. 9.8 +/- 1.8, p = 0.017).The conservative approach was viable in the great majority of patients with blunt splenic lesions, resulting in a drastic reduction in splenectomies. The need for transfusions did not increase, but the length of hospital stay increased. These results are concordant with other series from major centres, justifying this approach and constituting the challenge of its application in adults. |
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Evolution in the management of splenic trauma. Retrospective study in children.Evolução da atitude no traumatismo esplénico. Estudo retrospectivo em crianças.The treatment of blunt splenic lesions had changed in the last years with an increasing trend to conservative management. In the absence of national surveys, this paper is aimed to evaluate the results of this therapeutic approach in a group of Portuguese children.Patients with blunt splenic lesions, admitted over a period of 7 years, (n = 54) were retrospectively analysed. A group submitted to surgical treatment 'ab initio' (group A, from 1990 to 1992 incl.) was compared with a group managed by a conservative approach (group B, from 1993 to 1996 inclusive). Age, sex, associated lesions, treatment, need of a blood transfusion and length of hospital stay were studied.The frequency of splenic lesions was relatively stable (6 to 10 years) in both periods. Group A (n = 24) was similar to group B (n = 30) regarding gender and age. In group A, 23 (97%) splenectomies were performed. In group B, only six (20%) children underwent laparotomy and 4 (13%) of them were submitted to splenectomy (A vs. B, p < 0.001). The need of a blood transfusion was similar in the two groups and so were the associated lesions. The great majority of transfused children presented associated lesions (10/11, 91%). In group B, associated lesions did not significantly alter the effectiveness of the conservative treatment. Hospital stay was significantly longer in group B (B vs. A: 12.5 +/- 2.5 vs. 9.8 +/- 1.8, p = 0.017).The conservative approach was viable in the great majority of patients with blunt splenic lesions, resulting in a drastic reduction in splenectomies. The need for transfusions did not increase, but the length of hospital stay increased. These results are concordant with other series from major centres, justifying this approach and constituting the challenge of its application in adults.The treatment of blunt splenic lesions had changed in the last years with an increasing trend to conservative management. In the absence of national surveys, this paper is aimed to evaluate the results of this therapeutic approach in a group of Portuguese children.Patients with blunt splenic lesions, admitted over a period of 7 years, (n = 54) were retrospectively analysed. A group submitted to surgical treatment 'ab initio' (group A, from 1990 to 1992 incl.) was compared with a group managed by a conservative approach (group B, from 1993 to 1996 inclusive). Age, sex, associated lesions, treatment, need of a blood transfusion and length of hospital stay were studied.The frequency of splenic lesions was relatively stable (6 to 10 years) in both periods. Group A (n = 24) was similar to group B (n = 30) regarding gender and age. In group A, 23 (97%) splenectomies were performed. In group B, only six (20%) children underwent laparotomy and 4 (13%) of them were submitted to splenectomy (A vs. B, p < 0.001). The need of a blood transfusion was similar in the two groups and so were the associated lesions. The great majority of transfused children presented associated lesions (10/11, 91%). In group B, associated lesions did not significantly alter the effectiveness of the conservative treatment. Hospital stay was significantly longer in group B (B vs. A: 12.5 +/- 2.5 vs. 9.8 +/- 1.8, p = 0.017).The conservative approach was viable in the great majority of patients with blunt splenic lesions, resulting in a drastic reduction in splenectomies. The need for transfusions did not increase, but the length of hospital stay increased. These results are concordant with other series from major centres, justifying this approach and constituting the challenge of its application in adults.Ordem dos Médicos1998-11-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2347oai:ojs.www.actamedicaportuguesa.com:article/2347Acta Médica Portuguesa; Vol. 11 No. 11 (1998): Novembro; 961-4Acta Médica Portuguesa; Vol. 11 N.º 11 (1998): Novembro; 961-41646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2347https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2347/1765Correia-Pinto, JEstevão-Costa, Jinfo:eu-repo/semantics/openAccess2022-12-20T11:00:21Zoai:ojs.www.actamedicaportuguesa.com:article/2347Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:17:41.094173Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Evolution in the management of splenic trauma. Retrospective study in children. Evolução da atitude no traumatismo esplénico. Estudo retrospectivo em crianças. |
title |
Evolution in the management of splenic trauma. Retrospective study in children. |
spellingShingle |
Evolution in the management of splenic trauma. Retrospective study in children. Correia-Pinto, J |
title_short |
Evolution in the management of splenic trauma. Retrospective study in children. |
title_full |
Evolution in the management of splenic trauma. Retrospective study in children. |
title_fullStr |
Evolution in the management of splenic trauma. Retrospective study in children. |
title_full_unstemmed |
Evolution in the management of splenic trauma. Retrospective study in children. |
title_sort |
Evolution in the management of splenic trauma. Retrospective study in children. |
author |
Correia-Pinto, J |
author_facet |
Correia-Pinto, J Estevão-Costa, J |
author_role |
author |
author2 |
Estevão-Costa, J |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Correia-Pinto, J Estevão-Costa, J |
description |
The treatment of blunt splenic lesions had changed in the last years with an increasing trend to conservative management. In the absence of national surveys, this paper is aimed to evaluate the results of this therapeutic approach in a group of Portuguese children.Patients with blunt splenic lesions, admitted over a period of 7 years, (n = 54) were retrospectively analysed. A group submitted to surgical treatment 'ab initio' (group A, from 1990 to 1992 incl.) was compared with a group managed by a conservative approach (group B, from 1993 to 1996 inclusive). Age, sex, associated lesions, treatment, need of a blood transfusion and length of hospital stay were studied.The frequency of splenic lesions was relatively stable (6 to 10 years) in both periods. Group A (n = 24) was similar to group B (n = 30) regarding gender and age. In group A, 23 (97%) splenectomies were performed. In group B, only six (20%) children underwent laparotomy and 4 (13%) of them were submitted to splenectomy (A vs. B, p < 0.001). The need of a blood transfusion was similar in the two groups and so were the associated lesions. The great majority of transfused children presented associated lesions (10/11, 91%). In group B, associated lesions did not significantly alter the effectiveness of the conservative treatment. Hospital stay was significantly longer in group B (B vs. A: 12.5 +/- 2.5 vs. 9.8 +/- 1.8, p = 0.017).The conservative approach was viable in the great majority of patients with blunt splenic lesions, resulting in a drastic reduction in splenectomies. The need for transfusions did not increase, but the length of hospital stay increased. These results are concordant with other series from major centres, justifying this approach and constituting the challenge of its application in adults. |
publishDate |
1998 |
dc.date.none.fl_str_mv |
1998-11-30 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2347 oai:ojs.www.actamedicaportuguesa.com:article/2347 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2347 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/2347 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2347 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2347/1765 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 11 No. 11 (1998): Novembro; 961-4 Acta Médica Portuguesa; Vol. 11 N.º 11 (1998): Novembro; 961-4 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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