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Splenectomy for massive splenomegaly.

P Sharp, C S Grace, M C Rozenberg

The Australian and New Zealand Journal of Surgery

|October 1, 1985

Summary

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Splenectomy for massive splenomegaly (spleen >1.5kg) is a viable surgical option for hematological disorders. While complications like sepsis are common, long-term survival is achievable for many patients.

Area of Science:

Surgery
Hematology
Oncology

Background:

Massive splenomegaly, defined as a spleen weighing over 1.5 kg, often necessitates surgical intervention.
Serious hematological disorders, including non-Hodgkin's lymphoma and myelofibrosis, are primary indications for splenectomy.

Purpose of the Study:

To present the surgical technique for splenectomy in cases of massive splenomegaly.
To evaluate the short-term and long-term outcomes and complications associated with this procedure.

Main Methods:

Abdominal incisions were utilized for all splenectomies.
Key surgical steps included dividing splenic attachments, ligating the splenic artery, and posterior mobilization.

Main Results:

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Two operative deaths (5.3%) occurred, both attributed to sepsis.

Septic and thrombo-embolic complications were frequent, occurring both early and late post-surgery.

Of 24 patients surviving at least 1 year, 10 lived longer than 5 years.

Conclusions:

Splenectomy is a feasible procedure for massive splenomegaly, despite significant complication rates.
While early mortality is linked to sepsis, long-term survival is influenced by both the primary disease and other causes.