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Related Experiment Videos

Myeloproliferative disorders.

S I Schwartz

    Annals of Surgery
    |October 1, 1975
    PubMed
    Summary
    This summary is machine-generated.

    Surgical operations on patients with myeloproliferative disorders, including myeloid metaplasia (MM) and chronic myelogenous leukemia (CML), show acceptable risks. Splenectomy offers significant improvement for symptomatic MM and CML patients.

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    Area of Science:

    • Hematology
    • Surgical Oncology
    • Gastroenterology

    Background:

    • Myeloproliferative disorders (MPNs) can lead to significant splenomegaly and hematologic complications.
    • Portal hypertension is a recognized complication in some MPN patients, particularly those with myeloid metaplasia (MM).

    Purpose of the Study:

    • To evaluate the safety and efficacy of operative procedures in patients with myeloproliferative disorders.
    • To assess the role of splenectomy in managing symptomatic splenomegaly and hematologic issues in MM and chronic myelogenous leukemia (CML).
    • To investigate the contribution of augmented hepatic blood flow to portal hypertension in MPN patients.

    Main Methods:

    • Retrospective analysis of 43 operative procedures in 250 patients with MPNs.
    • Splenectomy performed on 21 patients with MM or CML for symptom palliation.

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  • Hemodynamic studies, including estimated hepatic blood flow (EHBF), conducted in patients with portal hypertension.

    • Main Results:

    • Overall operative mortality was 7%, with 5% experiencing excessive bleeding.
    • Eighty-four percent of patients undergoing splenectomy for MM or CML reported improvement in symptoms or hematologic parameters.
    • Splenectomy was associated with marked thrombocytosis in two patients.
    • Four patients with portal hypertension showed increased EHBF/Cardiac Index, and splenectomy relieved portal hypertension in these cases.

    Conclusions:

    • Operative procedures in well-prepared MPN patients have acceptable mortality and morbidity.
    • Splenectomy is indicated for symptomatic splenomegaly or hypersplenism in MM and CML, ideally performed early.
    • Hemodynamic assessment is crucial for guiding treatment decisions in MPN patients with portal hypertension and bleeding varices, determining the need for splenectomy alone or combined with shunting procedures.