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Related Experiment Videos

Changing indications for splenectomy. 30 years' experience

W D Traetow, P J Fabri, L C Carey

    Archives of Surgery (Chicago, Ill. : 1960)
    |April 1, 1980
    PubMed
    Summary

    Splenectomy rates have shifted, with Hodgkin

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    Area of Science:

    • Surgical Oncology
    • Hematology
    • Clinical Outcomes Research

    Background:

    • Over three decades, 2,4117 splenectomies were performed at The Ohio State University Hospital.
    • Indications included hypersplenism, incidental procedures, trauma, Hodgkin's staging, and other splenic diseases.

    Purpose of the Study:

    • To analyze trends in splenectomy indications.
    • To evaluate changes in morbidity and mortality rates.
    • To assess complications associated with splenectomy, particularly thrombocytosis.

    Main Methods:

    • Retrospective review of splenectomy cases over a 30-year period.
    • Analysis of patient data including indications, platelet counts, and complications.
    • Comparison of outcomes between different time periods.

    Main Results:

    • Hodgkin's staging is now the leading indication, replacing hypersplenism.
    • Thrombocytosis (platelet counts > 400,000/cu mm) occurred in 47% of patients, with 93% of thromboembolic complications in this group.
    • Overall morbidity decreased from 39% to 15%, and in-hospital mortality decreased from 9.5% to 6% in the last five years.

    Conclusions:

    • Splenectomy indications have evolved, with a rise in Hodgkin's staging.
    • Thrombocytosis post-splenectomy is a significant risk factor for thromboembolic events.
    • Recent outcomes show improved safety, but incidental splenectomies still carry risks.

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