AB101. SOH25_AB_259. Splenectomy in a tertiary referral centre: indications, temporal trends and procedure characteristics

Background: Due to changing trends in management of abdominal trauma, emergency splenectomy has become in infrequently performed procedure. Surgeons providing emergency general surgical care may still be required to perform splenectomy in severely injured, unstable patients. The aim of the current study was to examine trends in emergency and elective splenectomy in a tertiary hospital with examination of frequency, surgeon volume and indications for surgery.

Methods: Retrospective cohort study of all patients undergoing splenectomy in Cork University Hospital from 1st January 2005 to 31st December 2021. Variables assessed included procedure indications, patient characteristics, surgeon specialty and case volume, procedure characteristics and 30-day morbidity and mortality.

Results: A total of 161 splenectomies (110 planned and 51 unplanned) were performed during the study period. Trauma was the most common indication for splenectomy at the beginning of the study period but from 2013 onward the majority of splenectomies were performed for an oncological indication. The majority of splenectomies (65.8%) were performed by three surgeons with the remaining surgeons performing splenectomy at a rate of 0.20 splenectomies per surgeon per year. Patients undergoing unplanned splenectomy had higher rates of red cell transfusion, intensive care unit (ICU) admission and 30-day morbidity and mortality.

Conclusions: Splenectomy for trauma was performed infrequently by most surgeons. Experience in elective splenectomy was concentrated among a small number of surgeons potentially limiting opportunities to develop or maintain competence.

Keywords: Abdominal trauma; emergency general surgery; splenectomy; splenic injury; surgical training