Splenectomy has been performed for a variety of hematologic conditions in which the spleen is felt to exert a destructive effect on blood cells, thereby causing thrombocytopenia, anemia, leukopenia or combination on these.
Splenectomy has also been extremely useful in defining the extent of disease in Hodgkin’s lymphoma.
The authors retrospectively reviewed 135 splenectomy cases during the past 10 years from Feb. 1983 to Feb. 1993 at the Department of Surgery, Catholic Univeristy Medical College.
The results were as follows:
1) Common indications for splenectomy were leukemia (69 cases), ITP(49 cases) and hereditary spherocytosis(7 cases) in order. Among the 69 cases of leukemia. chronic myelocytic leukemia occurred in 66 cases, acute myelocytic leukemia in 2 cases, and hairy cell leukemia in 1 case.
2) the male to female sex ratio was 1:1.
3) The age incidence was in order of 31~40 years(45 cases), 21~30 years(37 cases) and 11~20 years(20 cases).
4) Significant hematologic recovery was obtained by splenectomy in 42 cases of ITP, response rate 86%, and complete hematologic recovery in all 7 cases of hereditory spherocytosis.
In cases of leukemic patients, there was no statistical significant improvement in hematologic finding, but symptomatic improvement could be obtained.
5) The most common post-operative complications were wound infections(5 cases), pulmonary complication(4 cases), wound hematoma(2 case), subphrenic abscess(1 case) and ileus (1 case). Operative morbidity was 11% and surgical mortality was 1.5%.
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