Outcomes of Splenectomy for Hematologic Diseases - A Single Center Experience

Splenectomy is a standard, effective and approved approach to the treatment of patients with failed medical treatment who develop recurrent, refractory or chronic diseases. The leading indications for elective splenectomy are benign and malignant hematologic diseases. We present here the findings of a retrospective analysis of the splenectomies performed in a single center for the treatment of hematologic diseases, and the associated outcomes. A retrospective examination was made of 64 patients who underwent splenectomy for the treatment of hematologic diseases at our clinic between 2010 and 2018. The patients were assessed for gender, age, hematologic disease, spleen size, presence of hepatomegaly, presence of accessory spleen, type of surgery (laparoscopic or open), wound site infection, preoperative and postoperative platelet counts, intraoperative and/or postoperative blood replacement, and length of hospital stay. The study sample comprised 23 (36%) male and 41 (64%) female patients, with a mean age of 40.4 years. Of the patients, 51 underwent laparoscopic splenectomy and 13 underwent splenectomy with laparotomy. Of the total, 57 (89%) patients responded fully to the splenectomy, six (9%) patients recorded a partial response and one (2%) patient had no response. Following the splenectomy procedure, one patient developed wound site infection and two patients died due to sepsis. Splenectomy should be considered a good treatment option in hematologic splenic diseases that are resistant to medical treatment, being also associated with low mortality and morbidity.

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1. Bonnet S, Guedon A, Ribeil J-A, Suarez F, Tamburini J, Gaujoux S. Indications and outcome of splenectomy in hematologic disease. Journal of visceral surgery 2017; 154: 421-429.

2. George JN, Woolf SH, Raskob GE, Wasser J, Aledort L, Ballem P, et al. Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology Blood. 1996; 88: 3-40.

3. British Committee for Standards in Haematology General Haematology Task Force. Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children and in pregnancy. Br J Haematol 2003; 120: 574-596.

4. McMillan R. The pathogenesis of chronic immune thrombocytopenic purpura. Semin Hematol 2007; 44: 3-11.

5. Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children and in pregnancy. Br J Hematol 2003; 120: 574-596.

6. Beardsley DS.ITP in the 21st century. Hematology Am Soc Hematol Educ Program 2006: 402-407.

7. Pamuk GE, Pamuk ÖN, Başlar Z, et al. Overview of 321 patients with idiopathic thrombocytopenic purpura. Retrospective analysis of the clinical features and response to therapy. Ann Hematol 2002; 81: 436-440.

8. Watson D, Coventry B, Chin T, Gill G, Malycha P. Laparoscopic versus open splenectomy for immune thrombocytopenic purpura. Surgery 1997; 121: 18-22.

9. Trias M, Targarona EM, Espert JJ, et al. Impact of hematological diagnosis on early and late outcome after laparoscopic splenectomy: an analysis of 111 cases. Surg Endosc 2000; 14: 556-560.

10. David PW, Williams DA, Shamberger RC. Immune thrombocytopenia: surgical therapy and predictors of response. J Pediatr Surg 1991; 26: 407-413.

11. Balague C, Targarona EM, Cerdan G, et al. Long-term outcome after laparoscopic splenectomy related to hematological diagnosis. Surg Endosc 2004; 18: 1283-1287.

12. Arnoletti JP, Karam J, Brodsky J. Early postoperative complications of splenectomy for hematologic disease. Am J Clin Oncol 1999; 22: 114-118.

13. Bisharat N, Omari H, Lavi I, Raz R. Risk of infection and death among post-splenectomy patients. J Infect 2001; 43: 182-186.

14. Hoffbrand AV, Pettit JE. Essential Haematology, 3rd edn. Bilbao: Blackwell Scientific Publications 1993: 318-331.

15. George JN, Woolf SH, Roskob GE, et al. Idiopathic thrombocytopenic purpura: A practice guideline developed by explicit methods for the American Society of Hematology. Blood 1996; 88: 3-40.

16. Jacir NN, Robertson FM, Crombleholme TM, Harris BH. Recurrence of immune thrombocytopenic purpura after splenectomy. J Pediatr Surg 1996; 31: 115-116.

17. Girgin S, Gedik E, Baç B, Taçyıldız Hİ. Benign Hematolojik Hastalıklarda Splenektomi Sonuçlarımız. Akademik Acil Tıp Dergisi 2008; 4: 42-45.

18. Stanton CJ. Laparoscopic splenectomy for idiopathic thrombocytopenic purpura. A five-year experience. Surg Endosc 1999; 13: 1083-1086.

19. Yalçın B, Tuğcu H, Kocabıyık N, et al. Aksesuar dalak. Gülhane Tıp Dergisi 2004; 46: 351-352.

20. Schwartz PE, Sterioff S, Mucha P, Melton LJ. 3rd, Offord KP, 1982. Post-splenectomy sepsis and mortality in adults. JAMA 248: 2279-2283.

21. Lutwick LI, 2005. Infections in asplenic patients. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles andPractice of Infectious Diseases. 6th ed. Philadelphia: Churchill Livingstone 3524-3532.
Eastern Journal of Medicine-Cover
  • ISSN: 1301-0883
  • Başlangıç: 1996
  • Yayıncı: ERBİL KARAMAN
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