EVIDENCE BASED MEDICINE IN SPLENIC DISEASES
| Autor: | K. A. Apartsin, S. E. Grigoriev |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Hepatology business.industry medicine.medical_treatment Splenectomy Gastroenterology Spleen Retrospective cohort study Cochrane Library medicine.disease Surgical pathology medicine.anatomical_structure Internal medicine medicine Surgery Cyst Splenic disease business Abscess |
| Zdroj: | Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 21:119-124 |
| ISSN: | 2408-9524 1995-5464 |
| DOI: | 10.16931/1995-5464.20161119-124 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|