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Splenectomy for the massively enlarged spleen.
1Surgery Branch, NCI/NIH, Bethesda, MD 20892.
The American Surgeon
|February 11, 1991
Summary
Splenectomy for massive splenomegaly offers benefits for many patients, particularly those with malignancy or hypersplenism. However, this surgical procedure carries significant risks of postoperative complications and mortality.
Area of Science:
- Oncology
- Surgical Pathology
- Hematology
Background:
- Massive splenomegaly, defined as spleen weight >= 1,500 grams, presents complex clinical challenges.
- Splenectomy is a potential treatment option for massive splenomegaly, but its risks and benefits require careful evaluation.
Purpose of the Study:
- To review the National Cancer Institute's experience with splenectomy for massive splenomegaly between 1955 and 1988.
- To assess the indications, pathology, operative details, and postoperative outcomes of this procedure.
Main Methods:
- Retrospective review of 46 patients who underwent splenectomy for massive splenomegaly.
- Analysis of patient demographics, indications for surgery, operative parameters, and postoperative complications.
Main Results:
- Most splenectomies (67.4%) were for hematologic malignancies, including chronic lymphocytic leukemia, chronic myelogenous leukemia, and lymphoma.
- Common indications included hypersplenism (32 patients) and symptoms (6 patients).
- The 30-day operative mortality was 19.6%, with a 39.1% postoperative complication rate, including infection and bleeding.
Conclusions:
- Splenectomy can provide significant benefits for carefully selected patients with massive splenomegaly.
- The procedure is associated with substantial postoperative morbidity and mortality, necessitating thorough patient selection and risk assessment.