The evolving indications for splenectomy

Browning, Matthew G.; Bullen, Naomi; Nokes, Timothy J.; Tucker, Keri; Coleman, Mark

doi:10.1111/bjh.14060

Cited by 30 publications

(37 citation statements)

References 7 publications

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“…Spontaneous splenic rupture due to malaria and rare cases of splenic infarction refractory to clinical treatment would be the few indications for splenectomy. 44,45 Complications/Laparoscopy The main complications of splenectomy are: haemorrhage, thromboembolism, subphrenic abscess, thoracic infection and fulminant sepsis following splenectomy (OPSI). The high rates of morbidity and mortality (30 per cent) are mainly due to haemorrhage, infections, and indication for myeloproliferative diseases, such as myelofibrosis and chronic granulocytic leukaemia.…”

Section: Malariamentioning

confidence: 99%

“…They should also undergo antibiotimicrobial chemoprophylaxis for the rest of their lives. 1,2,44 The risk of overwhelming post-splenectomy infection (OPSI) is both more common and closer to the date of splenectomy. It is characterized by rapid evolution, hypotension, altered consciousness, or cardio-circulatory shock.…”

Section: Malariamentioning

confidence: 99%

“…A conversion rate of 6.4 per cent has been reported mainly due to the degree of splenomegaly. 44,45 Conclusion Splenectomy, despite being indicated in several conditions, is still controversial and remains an open field for new studies, particularly in its relative indications. The procedure is curative alternative in a small number of diseases, although it is a complementary treatment procedure in several other clinical conditions.…”

Section: Malariamentioning

confidence: 99%

“…It is also an option for acquired and congenital erythrocyte and autoimmune diseases, as well as idiopathic splenomegaly. 3 The objective of the study was to review the clinical indications of splenectomy, to understand the pathophysiological aspects that it produces in the natural course of the diseases, and to review its indication in face of significant advances of biological and immunosuppressive therapies. Finally, the study also aims to provide the evidence that ensures the best moment in order to produce the desired effect and minimize postoperative complications.…”

Section: Introductionmentioning

confidence: 99%

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Splenectomy in non-traumatic diseases

Gomes¹,

Soares²,

Coccolini³

et al. 2018

AMJ

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Splenectomy represents the first choice for treatment of spontaneous splenic rupture, abscesses, cysts, tumours, and an alternative for control of hereditary, autoimmune, and myeloproliferative disorders. However, its relative indications have been reviewed for better understanding of both the primary affections and of splenectomy per se, particularly with regard to the immune system. The emergence of minimally invasive surgery, the possibility of splenic preservation, and availability of biological therapy has shown that the procedure has often been referred to as salvage therapy upon failure of other therapeutic propositions. On the other hand, patients have their general health status compromised by the underlying disease, by the use corticosteroids or biologic therapy, immunosuppressed, coagulation disorders, which contribute to the incidence of postoperative complications, such as infections, bleeding and venous thrombosis. Therefore, this scenario favours higher morbidity and mortality rates than those of other intra-abdominal surgical procedures. Thus, this review has the primary and comprehensive objective of purpose the best moment for splenectomy, when surgeons can interfere in the natural course of the disease increasing patients' quality of life and survival. In short, it is desired that the surgeon has complete knowledge of the profound physiological changes imposed on the host. In addition, to distinguish when it is curative and mandatory from when it must be put on hold due to other non-operative treatments with similar outcomes and, lastly, when it is not recommended for not aggregating survival. Key Words Splenectomy, splenomegaly, laparoscopyWhat this review adds: What is known about this subject?The indication of splenectomy in trauma patients is wellestablished; however in non-traumatic diseases it is much more controversial and current review and recommendations is scarce. What new information is offered in this review?This review explores the absolute and relative indications for splenectomy in different clinical sets. It also discourses on pathophysiological changes in an already compromised host. What are the implications for research, policy, or practice?Comprehensive review on the role of splenectomy in different non-traumatic settings, especially, haematological diseases in which it represents a rescue therapy because news biologic therapies.

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Section: Malariamentioning

confidence: 99%

Section: Malariamentioning

confidence: 99%

Section: Malariamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Splenectomy in non-traumatic diseases

Gomes¹,

Soares²,

Coccolini³

et al. 2018

AMJ

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“…Haematologic disorders with splenic involvement like hereditary haemolytic anaemias, idiopathic immune thrombocytopenia result in splenomegaly and may require splenectomy. (3) Other disorders in which splenectomy is indicated include non-cirrhotic portal hypertension, pancreatic neoplasms, chronic calcific pancreatitis with portal hypertension and lesions in neighbouring organs. Primary splenic pathology for which splenectomy may be performed include abscess, cysts, sarcoidosis and tumours which are comparatively rare.…”

mentioning

confidence: 99%

Histopathological Analysis of Splenectomy Specimens in a Tertiary Care Hospital- A Two-Year Study

Venkatesh¹,

Padmavathi²,

Devadas³

2018

jemds

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BACKGROUND Splenectomy is a rare surgical procedure performed worldwide. It is performed as an emergency procedure, especially in cases of traumatic injury and as an elective procedure for other causes. Apart from primary pathology involving spleen, splenectomy is performed for other disorders like pancreatitis and malignancy of stomach when secondary involvement of spleen is suspected. Haematologic disorders, both malignant and non-malignant, are other important indications for splenectomy. Worldwide studies have shown that trauma (45-75%) is the leading cause of splenectomy in low income countries and during wars, while haematologic causes (20-35%) account for majority of splenectomy in high income countries. Very few studies have been carried out in India, especially South India to analyse splenectomy causes and histomorphology. Aim-This study is a two-year retrospective descriptive study done on splenectomy specimens

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