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Am J Surg. 1999 Dec;178(6):581-6.

Splenectomy in high-risk patients with splenomegaly.

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  • 1Department of Surgery, University of Utah School of Medicine, Salt Lake City 84132, USA.

Abstract

BACKGROUND:

Splenectomy in patients with massive splenomegaly and hematologic malignancy results in higher morbidity and mortality with primarily palliative benefit.

METHODS:

From a 14-year experience with 172 splenectomies, the perioperative course of 39 high-risk patients with splenomegaly was reviewed for comorbidities, indications, complications, and mortality.

RESULTS:

Twenty-three males and 16 females with a mean age of 54.2 years and a mean 12.8-day postoperative length of stay were reviewed. Sixteen patients (41%) had 23 major complications related to age (P = 0.047) and operative time (P = 0.01). Intraoperative transfusion was related to splenic size (P = 0.04), and estimated blood loss (P = 0.02) was inversely related to use of splenic artery preligation. Three perioperative deaths were secondary to sepsis and multi-organ system failure.

CONCLUSION:

Splenomegaly and comorbidities of the primary disease result in higher morbidity and mortality. Splenic artery preligation is valuable to limit intraoperative blood loss and facilitate splenectomy.

PMID:
10670877
[PubMed - indexed for MEDLINE]
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