Surgical therapy of hematological disorders of spleen

Abstract

Splenectomy - the surgical removal of spleen is being performed in cases of: traumatic spleen rupture, as part of other surgical procedures, number of hematological, infectious and metabolic disorders. During the years 1988-2001, there were 396 splenectomies performed at the First surgical clinic, for the cause of: autoimmune disorders 187 (47,34%), lymphoproliferative diseases 89 (22,59%), Hodgkin disease 35(8,94%), myeloproliferative disease 39 (9,95%), as part a of "staging" laparotomy 37 (9,34%), other hematological disorders 7 (2,20%). The spleen of 244 patients weighted 500-1500 g (61,62%), in 56 patients (14,14%) weighted less than 500g, and in 96 patients (24,24%) spleen weighted more than 1500 g . Patients with thrombocytes less than 40000/l 16 (4,04%) were perioperativly treated with fresh thrombocytes. Postoperative morbidity and mortality were registered in 54 (13,64%), i.e. 8 (2.02%) patients. Delayed results depended on primary disorder, comorbidities and supportive therapy. In this article, the particularities of the operative procedure were discussed, as well as importance of cooperation of surgeon and hematologist in perioperative treatment.