sechenovSechenov Medical JournalСеченовский вестник2218-73322658-3348Сеченовский Университет10.47093/2218-7332.2025.16.2.30-38sechenov-1327Research ArticleSURGERYХИРУРГИЯShort-term outcomes of non-operative management of blunt splenic injury: a retrospective studyКраткосрочные результаты неоперативного лечения тупой травмы селезенки: ретроспективное исследованиеhttps://orcid.org/0009-0008-9826-8457НгуенК. Х.NguyenQ. H.

Нгуен Куанг Хюи, д-р мед. наук, заведующий отделением общей хирурги; преподаватель медицинского факультета

ул. Ши Ван Хань, 527, район 10, г. Хошимин, 700000

ул. Нгуен Тат Тхань, 300А, район 4, г. Хошимин, 700000

Quang H. Nguyen, Dr. of Sci. (Medicine), Head of the Department of General Surgery; Lecturer, Department of medicine

527, Su Van Hanh str., Ward 12, District 10, Ho Chi Minh City, 700000

300A, Nguyen Tat Thanh str., Ward 13, District 4, Ho Chi Minh City, 700000

drquanghuynguyen@gmail.comhttps://orcid.org/0009-0003-7645-9395ДангТ. К.DangT. K.

Данг Тоан Кхай, хирург отделения общей хирургии

ул. Ши Ван Хань, 527, район 10, г. Хошимин, 700000

Toan K. Dang, surgeon of the Department of General Surgery

527, Su Van Hanh str., Ward 12, District 10, Ho Chi Minh City, 700000

https://orcid.org/0009-0003-6922-7895ХоангШ. С.HoangS. X.

Хоанг Шонг Суан, хирург отделения общей хирургии

ул. Ши Ван Хань, 527, район 10, г. Хошимин, 700000

Song X. Hoang, surgeon of the Department of General Surgery

527, Su Van Hanh str., Ward 12, District 10, Ho Chi Minh City, 700000

Народная больница 115; Университет Нгуен Тат ТханьВьетнамPeople’s Hospital 115; Nguyen Tat Thanh UniversityViet NamНародная больница 115ВьетнамPeople’s Hospital 115Viet Nam2025310720251623038Copyright © Nguyen Q.H., Dang T.K., Hoang S.X., 20252025Нгуен К.Х., Данг Т.К., Хоанг Ш.С.Nguyen Q.H., Dang T.K., Hoang S.X.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sechenovmedj.com/jour/article/view/1327

Aim. To evaluate the short-term outcomes of non-operative management (NOM) for blunt splenic trauma and to identify prognostic factors for its success at a tertiary hospital.Methods. The study cohort comprised 136 patients with blunt splenic rupture treated at People’s Hospital 115, Ho Chi Minh City, Vietnam, between January 2021 and December 2023. Non-operative management was implemented in 91 cases (66.9%). Collected data included demographics, injury characteristics, therapeutic interventions, complications and NOM outcomes.Results. Among the 91 patients who received NOM, the median age was 34 (25; 47) years with male-to-female ratio of 6:1. Traffic accidents accounted for most splenic ruptures (81.3%). Clinical symptoms included abdominal pain (98.9%) and distension (27.5%). Abdominal computed tomography findings according to the American Association for the Surgery of Trauma (AAST) classification revealed predominantly Grade II (30.8%) and Grade III (38.5%) splenic injuries. The hemoperitoneum volume correlated significantly with injury severity (p = 0.029). NOM was successful in 88 patients (96.7%), whereas three patients (3.3%) required splenectomy. The median hospital stay was 5 (4; 6) days. The median amount of blood transfusion was 937.5 ± 340.9 ml. No mortality was reportedConclusions. Our findings confirm that NOM should be considered as a first-line therapy for hemodynamically stable patients with blunt splenic injury, as it safely obviates the need for surgery while avoiding operation-associated morbidity.

Цель. Оценить краткосрочные результаты неоперативного лечения (НОЛ) тупой травмы селезенки и прогностические факторы эффективности НОЛ в больнице третьего уровня.Материалы и методы. Исследуемая когорта включала 136 пациентов с разрывом селезенки в результате тупой травмы живота, проходивших лечение в Народной больнице 115, Хошимин, Вьетнам, в период с января 2021 по декабрь 2023 года. НОЛ было применено в 91 случае (66,9%). Для анализа собирались демографические данные пациентов, характеристики травмы, вид терапевтических вмешательств, характер осложнений и результаты лечения.Результаты. Средний возраст среди 91 пациента, получавшего НОЛ, составил 34 (25; 47) года, соотношение мужчин и женщин – 6:1. Большинство разрывов селезенки (81,3%) произошло в результате дорожнотранспортных происшествий. Клинические симптомы включали: боль в животе (98,9%) и вздутие (27,5%). Результаты компьютерной томографии брюшной полости в соответствии с классификацией Американской ассоциации хирургии травм (American Association for the Surgery of Trauma, AAST) выявили преимущественно повреждения селезенки II и III степени (30,8 и 38,5% соответственно). Объем гемоперитонеума статистически значимо коррелировал с тяжестью травмы (p = 0,029). НОЛ было эффективно у 88 пациентов (96,7%), тогда как трем пациентам (3,3%) потребовалась спленэктомия. Медиана пребывания в больнице составила 5 (4; 6) дней. Медиана объема переливания крови – 937,5 ± 340,9 мл. Летальных исходов не наблюдалось.Заключение. Наши результаты подтверждают, что НОЛ следует рассматривать как терапию первой линии для гемодинамически стабильных пациентов с тупой травмой селезенки, поскольку оно безопасно устраняет необходимость хирургического вмешательства и ассоциированных с ним осложнений.

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The authors declare that there are no conflicts of interest present.