Over a 12-year period, 180 splenic surgeries were performed at the Taegu Fatima Hospital, Major indications for splenic surgery were splenic injury(52.7%) and en-bloc surgery for stomach cancer(30.6%). Patients underwent splenic surgery became
doubled
in number during the latter 6 years(period II) compared with the former 6 years(period I). Major increases were noted in the patients with splenic injury, from 38 to 57, and patients who underwent en-bloc surgery for stomach cancer, from 14 to 41
which
was statistically singificant increase(p<0.01192). Whereas other indications of splenic surgery remained essentially unchanged. one hundred and forty four patients of 150 patients with splenic injury were injured due to blunt abdominal trauma and
49(34.0%) of them were treated nonoperatively. The incidence of nonoperative management during the period I and II were 35.6% and 32.9%, respectively.
Operative procedures for splenic pathologies consisted of splenectomy(91.7%) and splenic salvage procedures(8.3%). Between period I and II, patients who were carried out splenectomy had increased from 62 to 113 in number, and splenic salvage
procedure
from 5 to 10, but there were no statistical significance in their increases. Splenic salvage procedures(n=15) consisted of splenorrhaphy(n=9), autotransplantation of spleen tissue in the omental pouch(n=3), partial splenectomy(n=2), and
splenopexy(n=1).
Splenic salvage procedures were performed mainly in patients with splenic injury except 2 who underwent partial splenectomy for Gaucher's disease and splenopexy for wandering spleen, respectively.
In summary, a 12-year experience with splenic surgery has led to the following conclusions. Splenectomy was a major procedure for the greater part of splenic pathologies including Gaucher's disease and wandering spleen could be treated with
splenic
salvage procedures. If splenic salvage does not affect adversely to the underlying disease, operative indications and procedures for any of splenic pathologies should be selected carefully for preserving splenic function within the limits of
possibility.
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