Eficacia de la embolización de la arteria esplénica versus esplenectomía en pacientes con trauma esplénico contuso. Revisión sistemática

Abstract

Background: Blunt splenic trauma is one of the most common abdominal injuries in patients with multiple trauma. Traditionally, splenectomy was the standard treatment; however, splenic artery embolization has emerged as an effective, safe, and conservative alternative with better functional outcomes. Objective: To evaluate the effectiveness of splenic artery embolization (SAE) versus splenectomy in the management of blunt splenic trauma. Methodology: We included retrospective observational cohort studies published between 2019 and 2024, in Spanish and English, that analyzed conservative treatment via SAE and surgical management with splenectomy. Success rates, complications, and mortality were evaluated. The search was conducted in databases such as PubMed, Scopus, Web of Science, ProQuest, and Elsevier, as well as documents from health organizations. Fifteen retrospective studies were included, and the ROB-1 and NHLBI (2013) tools were applied to assess bias and methodological quality. Results: The studies reviewed showed that both splenic artery embolization (SAE) and splenectomy have high rates of therapeutic success. However, SAE was associated with fewer complications, shorter hospital stays, and lower mortality. Furthermore, it allowed splenic function to be preserved in most treated patients. Conclusions: Splenic artery embolization is an effective and safe alternative to splenectomy in patients with blunt splenic trauma. Its ability to preserve the spleen, reduce complications, and lower mortality makes it a therapeutic strategy of great clinical relevance. Keywords: spleen, embolization, splenectomy, trauma