Surgical outcomes and complications trauma-related solid organ resections: a systematic review and meta-analysis

Hassan Mashbari; Lama Alzelfawi; Ibrahim Momen; Lujain Alshamekh; Abdullah N. A. Alotibi; Sarah T. Baljun; Yasir Alsagoor; Nawaf Almutairi

doi:10.18203/2349-2902.isj20254332

Authors

Hassan Mashbari Department of Surgery, College of Medicine, Jazan University, Jazan, Saudi Arabia
Lama Alzelfawi Department of General Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
Ibrahim Momen College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Lujain Alshamekh College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
Abdullah N. A. Alotibi Department of Clinical Sciences, College of Medicine, Majmaah University, Riyadh, Saudi Arabia
Sarah T. Baljun College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
Yasir Alsagoor Department of Surgery, Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
Nawaf Almutairi Department of General Surgery, Security Forces Hospital, Riyadh, Saudi Arabia

DOI:

https://doi.org/10.18203/2349-2902.isj20254332

Keywords:

Trauma, Splenectomy, Nephrectomy, Solid organ injury, Postoperative complications, Mortality, Meta-analysis, Systematic review

Abstract

Trauma-related resections of solid organs, particularly the spleen and kidneys, are often necessitated in hemodynamically unstable patients. However, these interventions are associated with significant postoperative morbidity and mortality. This systematic review and meta-analysis followed PRISMA guidelines and registered on PROSPERO (CRD42024614171). Databases were searched for studies published between 2014 and 2024. Eligible studies reported outcomes of adult trauma patients undergoing surgical resection of solid organs (spleen, kidney, liver, bladder). Data extraction included baseline characteristics, surgical details, and postoperative complications. The risk of bias was assessed using the Cochrane RoB 1.0 and Newcastle-Ottawa Scale. Meta-analyses were performed using random-effects models. Fifteen studies comprising 50,537 patients were included. Splenectomy was the most frequently performed resection, followed by nephrectomy. Infectious complications were the most common adverse events postoperatively, particularly pneumonia and sepsis following splenectomy. Hemorrhagic complications and thromboembolic events were also observed. Pooled analysis showed no significant difference in hospital length of stay between resected and control groups (SMD=0.38 days; 95% CI: –5.28 to 6.04; I²=94%). Mortality odds were higher in the resection group (OR=1.42; 95% CI: 0.81 to 2.46), though not statistically significant (I²=49%). Trauma-related splenectomy and nephrectomy are associated with considerable risk of infectious and hemorrhagic complications and may confer higher but statistically non-significant mortality risk. These findings underscore the importance of organ-preserving approaches in trauma care and highlight the need for vigilant postoperative management in patients undergoing emergency solid organ resections.

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