European Pediatric Surgeons' Association Survey on the Use of Splenic Embolization in Blunt Splenic Trauma in Children

Anne Dariel; Tutku Soyer; Jens Dingemann; Alessio Pini-Prato; Leopoldo Martinez; Alice Faure; Mamane Oumarou; Sophie Hassid; Alexia Dabadie; Paolo De Coppi; Ramon Gorter; Tkashi Doi; Sanja Sindjic Antunovic; Mohit Kakar; Francesco Morini; Nigel J. Hall

doi:10.1055/s-0042-1749643

European Journal of Pediatric Surgery, Inhaltsverzeichnis

Eur J Pediatr Surg 2022; 32(06): 497-503
DOI: 10.1055/s-0042-1749643

Original Article

European Pediatric Surgeons' Association Survey on the Use of Splenic Embolization in Blunt Splenic Trauma in Children

Autor*innen

Anne Dariel

¹Pediatric Surgery Department, Assistance Publique des Hôpitaux de Marseille, Marseille, France
Tutku Soyer

²Pediatric Surgery Department, Hacettepe Universitesi Tip Fakultesi, Ankara, Turkey
Jens Dingemann

³Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
Alessio Pini-Prato

⁴UO Chirurgia Pediatrica, AON SS Antonio e Biago e Cesare Arrigo, Alessandria, Italy
Leopoldo Martinez

⁵Pediatric Surgery Department, Hospiltal Infantil La Paz, Madrid, Spain
Alice Faure

¹Pediatric Surgery Department, Assistance Publique des Hôpitaux de Marseille, Marseille, France
Mamane Oumarou

¹Pediatric Surgery Department, Assistance Publique des Hôpitaux de Marseille, Marseille, France
Sophie Hassid

⁶Pediatric Intensive Care Unit, Hôpital La Timone, Assistance Publique des Hôpitaux de Marseille, Marseille, France
Alexia Dabadie

⁷Pediatric Radiology Department, Assistance Publique des Hôpitaux de Marseille, Marseille, France
Paolo De Coppi

⁸Department of Paediatric Surgery, GOS Hospital for Children, London, United Kingdom of Great Britain and Northern Ireland
Ramon Gorter

⁹Pediatric Surgery Department, Emma Childrens' Hospital UMC, Amsterdam, the Netherlands
Tkashi Doi

¹⁰Pediatric Surgery Department, Kansai Medical University, Osaka, Japan
Sanja Sindjic Antunovic

¹¹Pediatric Surgery Unit, Medical Faculty University of Belgrade, Belgrade, Serbia
Mohit Kakar

¹²Pediatric Surgery Department, Children's Clinical University Hospital, Rīga, Latvia
Francesco Morini

¹³Neonatal Surgery Unit, Azienda Ospedaliero-Universitaria Meyer, University of Florence, Florence, Italy
Nigel J. Hall

¹⁴University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland

Abstract

Introduction This article assesses (1) access to splenic embolization (SE), (2) indications for SE, and (3) post-embolization management in high-grade splenic trauma in children.

Materials and Methods An online questionnaire was sent in 2021 to all members of European Pediatric Surgeons' Association.

Results There were a total of 157 responses (50 countries, 83% academic hospitals). Among them, 68% have access to SE (SE) and 32% do not (nSE). For a hemodynamic stable patient with high-grade isolated splenic trauma without contrast extravasation (CE) on computed tomography (CT) scan, 99% SE and 95% nSE respondents use nonoperative management (NOM). In cases with CE, NOM decreases to 50% (p = 0.01) and 51% (p = 0.007) in SE and nSE centers, respectively. SE respondents report a significant reduction of NOM in stable patients with an associated spine injury requiring urgent surgery in prone position, both without and with CE (90 and 28%, respectively). For these respondents, in stable patients the association of a femur fracture only tends to decrease the NOM, both without and with CE (93 and 39%, respectively). There was no significant difference in NOM in group nSE with associated injuries with or without CE. After proximal SE with preserved spleen vascularization on ultrasound Doppler, 44% respondents prescribe antibiotics and/or immunizations.

Conclusion Two-thirds of respondents have access to SE. For SE respondents, SE is used even in stable patients when CE showed on initial CT scan and its use increased with the concomitant need for spinal surgery. There is currently a variation in the use of SE and antibiotics/immunizations following SE.

Keywords

splenic trauma - embolization - children - survey

Volltext

Referenzen

References
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