Incidental splenectomy associated with Nissen fundoplication

Area of Science:

• Gastroenterology
• Surgical Pathology
• Clinical Outcomes Research

Background:

• Iatrogenic splenectomy, though relatively frequent, has an unclear impact on postoperative outcomes.
• Nissen fundoplication is a standard procedure for esophageal reflux.

Purpose of the Study:

• To compare postoperative morbidity and mortality between patients undergoing Nissen fundoplication alone versus those with combined iatrogenic splenectomy and Nissen fundoplication.

Main Methods:

• Retrospective comparative study.
• Analysis of 72 patients undergoing Nissen fundoplication (NF) and 25 patients undergoing both NF and iatrogenic splenectomy (NF+S).
• Comparison of hospital stay, morbidity rates, and mortality.

Main Results:

• The NF+S group had a longer average hospital stay (15 days vs. 9.4 days).
• Significantly higher postoperative morbidity (36% vs. 12.5%) was observed in the NF+S group (p < 0.1%).
• Complications in the NF+S group were more severe, with one mortality case.

Conclusions:

• Iatrogenic splenectomy combined with Nissen fundoplication substantially increases postoperative morbidity.
• The addition of splenectomy to Nissen fundoplication is associated with poorer patient outcomes.