ANATOMY OF VASCULATURE OF 850 SPLEEN SPECIMENS AND ITS APPLICATION INPARTIAL SPLENECTOMY

Background, Anatomic knowledge of vasculature of the splenic lobe and segment is of great clinical significance in partial resections and tr ansplantation of the spleen. Methods. The methods of two-colored corro sion casting roentgenography, and anatomic dissection were used to eva luate the vasculature of the splenic hilum and intraspleen. On this ba sis splenic lobectomy and segmentectomy were performed on 42 patients with traumatized spleens. Results. In the observation of 850 spleen sp ecimens the spleen showed a single lobar artery in 7 cases (0.8 %), tw o lobar arteries in 730 cases (86 %), three lobar arteries in 104 case s (12.2 %), and multiple lobar arteries (i.e., more than three lobar a rteries) in 9 cases (I %). In a subgroup of 276 specimens 17 %, 53 %, 24 %, 4 %, I %, and I % of spleen specimens had three, four, five, six , seven, and eight segmental arteries, respectively. The result from a subgroup of 280 specimens indicated that mean percentages of the exis tence of the superior and inferior polar arteries and of the coexisten ce of both polar arteries were 31.3 %, 38.8 %, and 13.3 %, respectivel y. Relative avascular planes between segments or lobes were seen. Basi c steps of splenic lobectomy, or segmentectomy include mobilization of the injured spleen, ligation of vessels in the lobe or segment, trans ection of the splenic;parenchyma, and sutures of the cut surface of th e remaining spleen. The postoperative courses of all 42 patients under going partial splenectomy were uneventful. No postoperative bleeding a nd necrosis of the remaining spleen or infectious complications were r egistered. Conclusions, Anatomically the spleen is defined with two pr imary lobes (the superior lobe and inferior lobe), one accessory lobe, and three to five segments. This new classification facilitates surge ons to perform partial resections of the spleen and allotransplantatio n of the hemispleen from a living related donor in human beings.