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Immunologische functie van de milt na embolisatie bij traumapatiënten

  • Origineel artikel
  • Published:
Nederlands Tijdschrift voor Traumatologie

Samenvatting

Na traumatisch miltletsel wordt naast operatie steeds vaker gekozen voor (a)selectieve coiling. Het vermoeden bestaat dat de immunologische functie van de milt daarmee gehandhaafd blijft, maar bewezen is dat nog niet. Voor de dagelijkse praktijk is het noodzakelijk een gemakkelijk te meten parameter te vinden om snel de resterende miltfunctie te kunnen bepalen. Dit om een weloverwogen keuze te kunnen maken voor eventuele vaccinaties en/of antibioticaprofylaxe om eenoverwhelming postsplenectomie infection (OPSI) te voorkomen. Voor deze review doorzochten we verschillende databases naar studies over de immunologische functie van de milt na embolisatie. Zeven studies werden gevonden. Veelal zijn de auteurs het erover eens dat de immunologische functie mogelijk gehandhaafd blijft, maar over een methode om dit objectief vast te stellen, is geen overeenstemming. Verder onderzoek is noodzakelijk om een betrouwbare en eenvoudige parameter te vinden voor het meten van de overgebleven miltfunctie na embolisatie.

Abstract

Splenic artery embolization, proximal or distal, is rapidly becoming the standard of care for traumatic splenic injury. Theoretically the immunological function of the spleen may be preserved, but this has not yet been proven. A parameter for measuring the remaining splenic function must therefore be determined to choose any vaccinations and/or antibiotic prophylaxis to prevent an overwhelming postsplenectomy infection (OPSI).

For this review, we searched several databases for studies on the immunological function of the spleen after embolization. Seven studies were found. Although most of the authors agree that the immunological function is preserved, there is still no consensus on how to prove this. Further research is necessary to find a parameter for measuring the residual splenic function after embolization.

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Authors and Affiliations

  1. afdeling Traumachirurgie, VUmc, Amsterdam, The Netherlands

    J.A.G. Schimmer

  2. Kinderchirurgisch Centrum, Emma Kinderziekenhuis, AMC/VUmc, Amsterdam, The Netherlands

    A.F.W. van der Steeg

  3. afdeling Traumachirurgie, VUmc, Amsterdam, The Netherlands

    W.P. Zuidema

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  1. J.A.G. Schimmer
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  2. A.F.W. van der Steeg
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  3. W.P. Zuidema
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student geneeskunde

kinderchirurg

traumachirurg

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Schimmer, J., van der Steeg, A. & Zuidema, W. Immunologische functie van de milt na embolisatie bij traumapatiënten. TIJD. TRAUMATOLOGIE 20, 74–79 (2012). https://doi.org/10.1007/s12506-012-0013-3

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