The implications for patients undergoing splenectomy: postsurgery risk management (original) (raw)
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Introduction: Hematological disorders are the most common indications for performing splenectomy after trauma in adults. The aim of this study is to investigate the treatment outcomes of splenectomy in hematological malignancy patients who were operated between the years 1998 and 2009. Patients and Methods: We analyzed the patients' clinical characteristics, type of surgical treatment, preoperative and postoperative medical treatments, complications and thrombocyte responses, retrospectively. Results: Seventeen male and 13 female patients, with a mean age of 50.7 (17-79), underwent splenectomy due to following indications: Hodgkin lymphoma (n= 10), Non Hodgkin lymphoma (n= 12), Chronic Lymphocytic lymphoma (n= 5), MALT lymphoma (n= 2) and Hairy Cell Leukemia (n= 1). The indications for surgery was splenomegaly and its complications (n= 20), gastric obstruction (n= 5), diagnosis splenic mass (n= 3), major bleeding (n= 1) and abscess (n= 1). Complications related to surgery occurred in 10 patients: pneumonia (n= 6), bleeding (n= 2), abscess (n= 1) and sepsis (n= 1). Early 30-day mortality was observed in two cases. During the follow-up period, platelet value revealed response in 19 (63.3%), partial response in 8 (26.7%) and unresponsive in 3 (10%) patients due to splenectomy. Conclusion: In conclusion; for hematological diseases, thrombocytopenia, massive splenomegaly and its complications, splenectomy is a safe method with acceptable complications rate and improves the patients' survival outcomes.
Sepsis after splenectomy: prophylaxis and treatment
JOURNAL OF SURGICAL AND CLINICAL RESEARCH, 2014
Infection is very important for the patient underwent splenectomy follow up, not only for the prevalence, but the lethality of disease. The following review is to summarize practical informations about the extent of knowledge of etiology, diagnosis, treatment and prophylaxis. The treatment starts early and appropriate prophylaxis are decisive for the prognosis of asplenia, being the focus of this study. To carry out this work a review of relevant literature of the last decade was taken. As a result, we emphasized extensively about the treatment and prophylaxis of the disease, but the large number of fatal outcomes, found until today, indicates that studies on early diagnosis and early treatment as well as prophylaxis, need to be improved. A infecção tem grande importância no acompanhamento do paciente submetido a esplenectomia, não só pela prevalência, mas pela letalidade da doença. A presente revisão busca sintetizar informações de forma prática, no âmbito do conhecimento da etiologia, diagnóstico, tratamento e profilaxia. O tratamento iniciado precocemente e a profilaxia correta são decisivas para o prognóstico dos asplênicos, sendo o foco desse estudo. Para realização desse trabalho foi feita revisão de literatura relevante da última década. A pesquisa bibliográfica evidenciou que há esquemas de condutas Sepsis after splenectomy: prophylaxis and treatment Araújo-Filho I, et al J Surg Cl Res -Vol. 5 (1) 2014:56-64 57 médicas amplamente já utilizados a cerca do tratamento e profilaxia da doença. Um grande número de desfechos fatais, encontrados até os dias atuais, nos indica que estudos sobre diagnóstico e início do tratamento precoce, assim como a profilaxia, merecem ser aperfeiçoados.
Surgical removal of the spleen, splenectomy, is a procedure that has significantly decreased in frequency as our understanding of the infectious complications of the asplenic state increased. The full spectrum and details of splenic function, however, have yet to be fully outlined. As a result, our comprehension of the long-term consequences of splenectomy remains incomplete. We review the evidence relating to the effects of splenectomy on infection, malignancy, thrombosis, and transplantation. Perhaps the best-defined and most widely understood complication of splenectomy is the asplenic patient's susceptibility to infection. In response to this concern, novel techniques have emerged to attempt to preserve splenic function in those patients for whom surgical therapy of the spleen is necessary. The efficacy of these techniques in preserving splenic function and staving off the complications associated with splenectomy is also reviewed in this article.
Outcomes Of Splenectomy For Hematologic Diseases - A Single Center Experience
Eastern Journal of Medicine, 2021
Splenectomy is a standard, effective and approved approach to the treatment of patients with failed medical treatment who develop recurrent, refractory or chronic diseases. The leading indic ations for elective splenectomy are benign and malignant hematologic diseases. We present here the findings of a retrospective analysis of the splenectomies performed in a single center for the treatment of hematologic diseases, and the associated outcomes. A retrospective examination was made of 64 patients who underwent splenectomy for the treatment of hematologic diseases at our clinic between 2010 and 2018. The patients were assessed for gender, age, hematologic disease, spleen size, presence of hepatomegaly, presence of accessory spleen, type of surgery (laparoscopic or open), wound site infection, preoperative and postoperative platelet counts, intraoperative and/or postoperative blood replacement, and length of hospital stay. The study sample comprised 23 (36%) male and 41 (64%) female patients, with a mean age of 40.4 years. Of the patients, 51 underwent laparoscopic splenectomy and 13 underwent splenectomy with laparotomy. Of the total, 57 (89%) patients responded fully to the splenectomy, six (9%) patients recorded a partial response and one (2%) patient had no response. Following the splenectomy procedure, one patient developed wound site infection and two patients died due to sepsis. Splenectomy should be considered a good treatment option in hematologic splenic diseases that are resistant to medical treatment, being also associated with low mortality and morbidity.
Long-term outcome after laparoscopic splenectomy related to hematologic diagnosis
Surgical Endoscopy and Other Interventional Techniques, 2004
Background Laparoscopic splenectomy (LS) has been demonstrated as an effective and safe treatment for hematological disorders requiring spleen removal, especially in cases of normal-sized spleens. However, although results are promising, long-term outcome data are lacking. We reviewed our clinical experience with LS in a series of 255 cases, with particular attention to the long-term outcome related to the disease process requiring LS. Methods From February 1993 to October 2003, LS was attempted in 255 patients (100 males and 155 females with a mean age of 45 ± 19 years) and clinical information was recorded in a prospective database. Indications for splenectomy included idiopathic thrombocytopenic purpura (ITP) (n = 115), HIV-ITP (n = 9), Evans syndrome (n = 6), autoimmune hemolytic anemia (AIHA) (n = 13), hereditary spherocytosis (HS) (n = 19), hematologic malignancy (n = 66), thrombotic thrombocytopenic purpura (n = 1), and others (n = 26). Long-term postoperative follow-up evaluation was obtained through clinical notes, follow-up visits by the referring hematologist, and by phone interviews both with patients and with the referring hematologist. Results A total of 186 patients (73%) were available for a mean follow-up of 35 months (range, 1–104). Of the ITP patients, 87 (76%) were followed up, with a remission rate of 89% (complete remission in 75%). A similar remission rate was observed in ITP-HIV; in patients available for follow-up (78%), complete remission was achieved in 83%. In Evans, complete remission was achieved in all patients available for follow-up (67%). Clinical response for hemolytic disease ranged between 70% for AIHA and 100% for HS. In the malignant group, the late mortality rate was 22%. The mortality rate in the miscellaneous group was 5%. No cases of splenectomy-related sepsis occurred during follow-up. Conclusions LS offers advantages for all types of splenic diseases requiring surgery. It provides not only good clinical short-term outcome but also satisfactory long-term hematological results.
Laparoscopic Splenectomy in the Treatment of Hematological Diseases of the Spleen
Serbian Journal of Experimental and Clinical Research, 2019
Methods of surgical treatment of hematological diseases of the spleen have changed significantly in the past decade. The introduction of laparoscopic and minimally invasiveprocedures as standard for solving a significant number of conditions in abdominal surgery, has led surgeons toincreasingly use laparoscopic surgery of the spleen. However, some unique anatomical characteristics of the spleen can lead to limitation in the application of laparoscopy. In this study, we investigated the application of laparoscopic splenectomy in the treatment of haematological disorders of the spleen, intraoperative and postoperative characteristics, the presentation ofoperational technique and the evaluation of the success of this procedure. In the treatment of benign hematological diseases, the effectiveness and efficiency of laparoscopy has been proven. The speculation of medical professionals is that laparoscopic splenectomy is an equal, if not the superior way of treating benign hematological di...
Splenectomy; Postoperative Splenectomy Complications
THE PROFESSIONAL MEDICAL JOURNAL
To analyze the complications following elective splenectomy. Study Design: Descriptive cross-sectional. Setting and Duration: This study was conducted in the department of surgery, Madinah Teaching Hospital, Faisalabad from January 2011 to December 2016. Method: After a good preoperative workup and preparation, 112 patients underwent elective open splenectomy from Jan 2011 to Dec 2016. Early postoperative complications were recorded. P value <0.05 was considered significant. Results: Of 112 patients, 09 patients (8%)presented with postoperative complications i.e, thrombocytosis in 4 patients (3.57%), haemorrhage in 2 patients (1.79%), chest infection in 1, meningitis in 1 (0.89%) and ileus in 1 (0.89%). Mortality was seen in 1 patient (0.89%). The two patients with fatal postoperative haemorrhage re-explored. One patient survived and other patient expired. Statistical analysis showed significance of study, a P value of 0.01. Conclusion: In our institution complication rate followingsplenectomy is equivalent to recent studies that is related to a good preoperative workup, excellent surgical technique and a vigilant postoperative care.