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Splenectomy for massive splenomegaly.

J H Shaw1, M Clark

  • 1University Department of Surgery, Auckland Hospital, New Zealand.

The British Journal of Surgery
|April 1, 1989
PubMed
Summary
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Resecting giant spleens (over 1.5 kg) is beneficial, with minimal serious complications. Adrenaline injection safely reduces spleen size, aiding surgical procedures and improving patient outcomes.

Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Hematology

Background:

  • Giant spleens, defined as weighing over 1.5 kg, present unique surgical challenges.
  • Spleen resection is indicated for symptomatic relief and management of hematological abnormalities.

Purpose of the Study:

  • To review the difficulties and benefits of resecting giant spleens.
  • To evaluate the safety and efficacy of adrenaline injection into the splenic artery to reduce technical difficulty during surgery.

Main Methods:

  • Retrospective review of 24 patients who underwent giant spleen resection.
  • Analysis of operative outcomes, complications, and patient benefits.
  • Assessment of splenic volume reduction following adrenaline injection.

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Main Results:

  • While morbidity was higher than for smaller spleens, serious complications were infrequent, with no operative or in-hospital deaths.
  • Nearly all patients experienced benefits, including improved hematological parameters or symptom palliation.
  • Adrenaline injection reduced splenic volume by approximately 40%, facilitating surgical exposure.

Conclusions:

  • Giant spleen resection is a safe and beneficial procedure.
  • Adrenaline injection is a valuable adjunct for reducing technical difficulty and improving surgical outcomes in giant spleen resections.