Late results of splenectomy in hematologic disorders

During the past 27 years from 1944 to 1970 splenectomy was performed on 53 patients including 33 idiopathic thrombocytopenic purpura (ITP), 13 hereditary spherocytosis and 7 hypoplastic anemia. Their clinical and laboratory findings in immediate and late postoperative periods were compared with those received medical treatment alone. In the chronic form of ITP the effect of medical treatment alone is only transitory and not curative. Splenectomy seems to be the treatment of choice in this situation which produces long term favorable results regardless of patient's response to preoperative steroid treatment. In hereditary spherocytosis the improvement in the morphology of red blood cells was limited after splenectomy, but considerable improvement was achieved in hemolytic tendency. Therefore, splenectomy would be the first choice. In hypoplastic anema splenectomy did not produce, in general, favorable results as compared in ITP or hereditary spherocytosis. However, when the patient responded to steroid treatment preoperatively, splenectomy could have reduced the frequency and amount of blood transfusion. Splenectomy would then be contemplated in such situations.