Omentum Rotational Flap for Spleen Autotransplantation in Splenic Trauma — Experimental Study

Abstract

Intra-omental splenic autotransplantation is the only method described so far to preserve spleen function after splenectomy; however, it is associated with some postoperative complications. The present study aimed to compare the effectiveness and feasibility of an omentum rotational flap (ORF) with the spleen auto transplant in the omentum (SAO) for preserving splenic function. Forty male Wistar rats were equally divided into two ORF and SAO groups. White blood cell (WBC), hemoglobin (Hb), platelet, immunoglobulin A, M, and G (IgA, IgM, IgG), and complement levels (C3, C4) were measured before and 4 weeks after the surgery. Technetium-99 m scintigraphy was performed to assess the postoperative splenic function in both groups. There was no significant difference between the groups’ preoperative hematological factors. The Hb, C3, C4, IgM, and IgA levels were significantly decreased after intervention in both groups (p < 0.05), and the WBC and platelet counts were significantly reduced after surgery in ORF and SAO groups, respectively. The postoperative level of WBC was significantly lower in ORF compared to the SAO group (p < 0.001). The radioisotope uptake was decreased after surgery in both groups (p < 0.05), and no significant difference was observed in terms of improving radioisotope uptake between the groups (p = 0.63). The duration of surgery was significantly higher in the SAO compared to the ORF group (p < 0.001). In splenic injuries, the omentum rotational flap technique instead of spleen auto transplant in the omentum seems to be an effective surgical method for preserving the function of the spleen, but the evaluation of its safety needs more clinical study. © Association of Surgeons of India 2023.