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Splenectomy in hematologic disorders. The ever-changing indications.

M C Wilhelm1, R E Jones, R McGehee

  • 1Department of Surgery, University of Virginia Medical Center, Charlottesville 22908.

Annals of Surgery
|May 1, 1988
PubMed
Summary
This summary is machine-generated.

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Splenectomy rates significantly increased from 1963-1982 compared to 1946-1962, driven by evolving lymphoma staging. Mortality rates decreased, with no deaths after 1979.

Area of Science:

  • Surgical Oncology
  • Hematology
  • Clinical Outcomes Research

Background:

  • Splenectomy practices for hematologic disorders have evolved over time.
  • Changes in surgical indications and diagnostic techniques influence procedure frequency.
  • Understanding historical trends in splenectomy is crucial for current clinical practice.

Purpose of the Study:

  • To compare splenectomy procedures performed for hematologic disorders across two distinct time periods (1946-1962 and 1963-1982).
  • To identify factors contributing to observed changes in splenectomy incidence and indications.
  • To evaluate the impact of these changes on patient mortality rates.

Main Methods:

  • Retrospective analysis of splenectomy cases performed at the University of Virginia Medical Center.

Related Experiment Videos

  • Comparison of data from two series: 1946-1962 (Series I) and 1963-1982 (Series II).
  • Analysis of procedure indications, patient outcomes, and associated mortality.

    • Main Results:

    • Splenectomy rates increased substantially in Series II (20/year) compared to Series I (5.5/year).
    • The evolution of staging laparotomy for lymphomas, particularly Hodgkin's disease, was a major driver of increased splenectomy rates.
    • Mortality rates decreased from 6.3% in Series I to 4.0% in Series II, with no deaths recorded after 1979.

    Conclusions:

    • The incidence of splenectomy for hematologic disorders has significantly changed over the decades.
    • Shifting diagnostic and therapeutic strategies, especially for lymphomas, have altered splenectomy indications.
    • Improved surgical techniques and patient management have led to reduced mortality associated with splenectomy.