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Splenectomy for massive splenomegaly.

W W Coon1

  • 1Department of Surgery, University of Michigan Medical Center, Ann Arbor.

Surgery, Gynecology & Obstetrics
|September 1, 1989
PubMed
Summary
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Surgical removal of massively enlarged spleens (≥1,500g) in patients with myeloproliferative disorders does not increase morbidity or mortality, except for increased blood loss in non-Hodgkin

Area of Science:

  • Hematology
  • Surgical Oncology
  • Internal Medicine

Background:

  • Massively enlarged spleens (≥1,500g) are associated with myeloproliferative disorders.
  • Previous reports suggest increased morbidity following splenectomy for massive splenomegaly.

Purpose of the Study:

  • To evaluate the operative morbidity and mortality associated with splenectomy in patients with massively enlarged spleens.
  • To compare outcomes in patients with massive splenomegaly versus those with smaller spleens.

Main Methods:

  • Retrospective review of patients undergoing splenectomy for massively enlarged spleens.
  • Comparison of complication rates, operative blood loss, and mortality between patients with massive splenomegaly and those with smaller spleens.

Main Results:

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  • 46 of 51 patients with massively enlarged spleens had myeloproliferative disorders.
  • No significant increase in overall morbidity or mortality was observed compared to patients with smaller spleens.
  • Increased operative blood loss was noted in patients with non-Hodgkin's lymphoma and massive splenomegaly.

Conclusions:

  • Splenectomy for massively enlarged spleens in myeloproliferative disorders can be performed with acceptable morbidity.
  • Careful patient selection and perioperative management are crucial for limiting complications.
  • Outcomes are comparable to splenectomy for smaller spleens, with the exception of increased blood loss in specific hematologic malignancies.