[Indications for splenectomy in non-malignant systemic diseases].

Area of Science:

• Internal Medicine
• Hematology
• Pathology

Background:

• Benign systemic disorders encompass a range of conditions affecting multiple organs, including the spleen.
• Hematologic diseases, thesaurismosis, collagenosis, Morbus Boeck, infections, and parasitic infestations are key categories of splenic involvement.
• Hematologic conditions of the erythrocytic, thrombocytic, and lymphatic systems, alongside myeloproliferative and aplastic syndromes, constitute the majority of cases.

Purpose of the Study:

• To analyze the indications and outcomes of splenectomies performed for benign systemic disorders.
• To evaluate the role of hypersplenism as a primary indication for surgical intervention.
• To discuss optimal management strategies, including pre-operative treatment and combined therapeutic approaches.

Main Methods:

• Retrospective analysis of 1214 splenectomies performed over a 20-year period.
• Identification and categorization of cases associated with benign systemic diseases.
• Review of patient records to determine indications for surgery, pre-treatment, and post-operative management.

Main Results:

• A total of 227 splenectomies (18.7%) were performed for benign systemic diseases.
• Hematologic disorders accounted for the vast majority of these cases (approximately 80%).
• Functional and mechanical hypersplenism were identified as the predominant reasons for splenectomy.

Conclusions:

• Splenectomy is a significant intervention for managing complications arising from benign systemic disorders, particularly hematologic conditions.
• Hypersplenism is a critical factor driving the decision for splenectomy in this patient cohort.
• A multidisciplinary approach combining medical and surgical management is essential for optimizing patient outcomes.