Splenic Volume Changes After Left Nephrectomy: A Retrospective Computed Tomography-Based Morphometric Study

Background/Objective: Spleen volume can vary depending on physiological conditions, systemic diseases, and various clinical factors. However, the relationship between the anatomical changes resulting from the surgical removal of an organ adjacent to the spleen and spleen volume has not been sufficiently studied. The aim of this study was to evaluate changes in spleen volume following left nephrectomy and to investigate the associations of sex and the time interval between preoperative and postoperative computed tomography (CT) examinations with these changes. Methods: In this retrospective study, preoperative and postoperative abdominal CT images of 62 patients (30 women, 32 men; age range 37-85 years) who underwent left radical nephrectomy were evaluated. Spleen volume was calculated by manually delineating the spleen borders on axial CT slices and using the TeraRecon imaging system. Preoperative and postoperative spleen volumes were compared; furthermore, the relationship between volume change and sex, as well as the time interval between the two CT scans, was evaluated. Results: The mean spleen volume was 238.41 ± 80.99 cm³ before surgery and was found to be 259.81 ± 104.40 cm³ after surgery. An average increase of 9.0% in spleen volume was observed following nephrectomy, and this increase was statistically significant (p = 0.005). Although spleen volume increased in both women and men, the change in volume did not show a significant difference based on sex (14.07 ± 53.69 cm³ in women; 28.28 ± 62.32 cm³ in men; p = 0.339). No statistically significant difference in splenic volume change was detected between the predefined CT-interval groups (p = 0.633). Postoperative imaging time was not significantly correlated with splenic volume change when analyzed continuously (Spearman's ρ = -0.128, p = 0.320). Conclusions: Mean CT-derived splenic volume was higher on postoperative than on preoperative examinations. However, because the study lacked a control group and longitudinal data on relevant clinical confounders, this difference cannot be attributed specifically to left nephrectomy or interpreted as definitive evidence of true splenic hypertrophy.