Comparison of splenic embolization and splenectomy for traumatic splenic rupture: a meta-analysis.

ABSTRACT

INTRODUCTION: This study aims to assess the safety and clinical efficacy of percutaneous splenic embolization (PSE) and splenectomy as approaches to treating cases of traumatic splenic rupture (TSR). MATERIAL AND METHODS: Eligible articles published throughout August 2023 were identified. Endpoints compared between PSE and splenectomy patient groups included operative time, intraoperative hemorrhage, duration of hospitalization, postoperative complication rates, and measures of immune function. RESULTS: Thirteen studies, involving 474 and 520 patients in the PSE and splenectomy groups respectively, were incorporated into this meta-analysis. As compared to the splenectomy group, individuals treated via PSE exhibited a significant reduction in pooled operative time (p < 0.00001) and hospitalization duration (p < 0.00001), with corresponding reductions in rates of intraoperative hemorrhage (p < 0.00001), total complications (p < 0.0001), incisional infection (p < 0.0001), ileus (p = 0.0004), and abdominal infection (p = 0.02). The immune status of these PSE group patients was also improved, as evidenced by significantly higher pooled CD4+ (30 days), CD4+/CD8+ (30 days), and CD3+ (30 days) values (p < 0.0001, 0.0001, and 0.0001, respectively). CONCLUSIONS: Compared to splenectomy, PSE-based TSR treatment can significantly reduce operative time, rate of postoperative complications, and incidence of intraoperative hemorrhage, while improving post-procedural immune functionality.