Splenectomy in haematological diseases; Single center experience

Abstract

Splenectomy is an important treatment option in some haematologic diseases which are aggressive and refractory to medical treatment. Splenectomy is also used for diagnosis for some of the hematologic diseases. In this study, we aimed to present the patients and the results of the diagnostic and therapeutic splenectomy due to haematologic diseases. In this study, between September 2005 and May 2011, in Ondokuz Mayis University Faculty of Medicine, 184 patients with splenectomy were retrospectively reviewed. Fifty four patients were included who applied to Haematology Clinic and had splenectomy due to haematological diseases. 34 (63%) of patients were female and 37% (20) were male. The mean age was 43.93±16.9. The most common haematologic disease for which splenectomy was immune thrombocytopenic purpura (ITP) (70.4%). Splenectomy was applied for therapeutic purpose in 53 patients and for diagnostic purpose in 1 patient. The pathology result was Hodgkin lymphoma in the patient who receieved diagnostic splenoctomy. The most common presenting symptoms of the patients were skin lesions (petechiae, purpura, ecchymosis). Spleen size had within the normal range in 38 (70.4%) patients. Normal spleen size was observed in 35 ITP patients (92.1%) . 16 patients (29.6%) had hepatomegaly. Accessory spleen was found in 13% of patients during surgery. The most frequently reported result of splenic pathology was found to be hypersplenism. 46 patients before surgery, 16 patients after the surgery had pneumococcal and haemophilus influenza vaccines. Meningococcal vaccine could not be done because it could not be obtained. Death due to surgical complications was not observed. As a result, splenectomy,is still used for diagnosis and treatment in hematological diseases, at diagnosis and treatment remains up to date. The development of new diagnostic and treatment methods would decrease the frequency of splenectomy in some hematologic diseases. However, large multi-center case-serial publications will be needed. © 2012 OMU.