PL EN


Preferences help
enabled [disable] Abstract
Number of results
2007 | 79 | 6 | 426-435
Article title

Splenectomy in Patients with Hematological Disorders - Our Experience

Content
Title variants
Languages of publication
EN
Abstracts
EN
The aim of the study. Retrospective analysis of indications for splenectomy in hematological diseases, positive effect of this operation and correlations between objective prognostic factors and good response to splenectomy in patients with different hematological indications for splenectomy.Material and methods. 98 adult patients with hematological disorders, who were splenectomised in the years 1994 - 2004. We evaluated the effects of splenectomy in patients with hematological diseases as defined by patient documentation from the 2nd Department of General and Oncological Surgery, Department of Hematology and Hematological Ambulance and the questionnaires that patients completed by themselves.Results. The beneficial effect of splenectomy was observed in the majority of cases of idiopathic thrombocytopenic purpura (41 of 53 patients), acquired hemolytic anemia (2 of 3 patients) and hereditary spherocytosis (8 of 9 patients). Surgery can provide a high frequency of durable response for adult patients with benign hematological disorders. In malignant hematological diseases, splenectomy eliminates consequences of hypersplenism or splenomegaly. Splenectomy in patients with malignant hematological disorders can improve their condition and relieve symptoms of hypersplenism and splenomegaly to improve their quality of life. There were early complications in 11 patients (11.3%). Mortality was 2%. Late complications appeared in 24 patients out of 96 patients, who survived the perioperative period. The most common late complication was moderate respiratory infections.Conclusions. Splenectomy is the most common operation in patients with hematological disorders. Indications for splenectomy have been hindered by the lack of any objective prognostic factors of good postoperative response. Nevertheless, the effect of splenectomy is positive in many patients with benign and malignant hematological diseases.
Publisher

Year
Volume
79
Issue
6
Pages
426-435
Physical description
Dates
published
1 - 6 - 2007
online
27 - 11 - 2007
Contributors
  • Department of General and Oncological Surgery, Medical University, Wrocław
  • Department of General and Oncological Surgery, Medical University, Wrocław
  • Department of General and Oncological Surgery, Medical University, Wrocław
  • Department of General and Oncological Surgery, Medical University, Wrocław
  • Department of General and Oncological Surgery, Medical University, Wrocław
author
author
  • Department of General and Oncological Surgery, Medical University, Wrocław
  • Department of General and Oncological Surgery, Medical University, Wrocław
References
  • Ultrasonografia śledziony. Walas K (red.). Wydaw. Medyczne MAKmed, Gdańsk 1996.
  • Wood L, Baker PM, Martindale A et al.: Splenectomy in haematology - a 5-year single centre experience. Hematology 2005; 10: 505-509.[PubMed]
  • Bellows CF, Sweeney JF: Laparoscopic splenectomy: present status and future perspective. Expert Rev Med Devices. 2006; 3: 95-104.[Crossref]
  • Misiak A, Kucharski W, Szczepanik AB i wsp.: Splenektomia laparoskopowa w chorobach hematologicznych. Pol Przegl Chir 2002; 11: 950-58.
  • Pugliese R, Maggioni D, Scandroglio I et al.: Splenectomy in haematologic diseases. Clinical indications and surgical technique. Chir Ital 2005; 57: 283-91.
  • Stanek A, Stefaniak T, Makarewicz W et al.: Accessory spleens: preoperative diagnostics limitations and operational strategy in laparoscopic approach to splenectomy in idiopathic thrombocytopenic purpura patients. Langenbecks Arch Surg 2005; 390: 47-51.
  • Walters DN, Roberts JL, Votaw M: Accessory splenectomy in the management of recurrent immune thrombocytopenic purpura. Am Surg 1998; 64: 1077-78.
  • Kojouri K, Vesely SK, Terrell DR et al.: Splenectomy for adult patients with idiopathic thrombocytopenic purpura: a systematic review to assess longterm platelet count responses, prediction of response, and surgical complications. Blood 2004; 104: 2623-34.
  • Scharf R, Ziemski JM: Chirurgia śledziony. W: Podstawy chirurgii. Szmidt J. (red.). Medycyna Praktyczna, Kraków 2004, 1025-39.
  • Stasi R, Provan D: Management of immune thrombocytopenic purpura in adults. Mayo Clin Proc 2004; 79: 504-22.[Crossref][PubMed]
  • Duperier T, Brody F, Felshér J et al.: Predictive factors for successful laparoscopic splenectomy in patients with immune thrombocytopenic purpura. Arch Surg 2004; 139: 61-66.
  • Katkhouda N, Grant SW, Mavor E et al.: Predictors of response after laparoscopic splenectomy for immune thrombocytopenic purpura. Surg Endosc 2001; 15: 484-88.[PubMed][Crossref]
  • Pace DE, Chiasson PM, Schlachta CM et al.: Laparoscopic splenectomy for idiopathic thrombocytopenic purpura (ITP). Surg Endosc 2003; 17: 95-98.
  • Schwartz J, Leber MD, Gillis S et al.: Long term follow-up after splenectomy performed for immune thrombocytopenic purpura (ITP). Am J Hematol 2003; 72: 94-98.
  • Stoehr GA, Stauffer UG, Eber SW: Near-total splenectomy: a new technique for the management of hereditary spherocytosis. Ann Surg 2005; 241: 40-47.
  • Misiak A, Szczepaniak A, Huszcza S et al.: Splenektomia laparoskopowa a splenektomia klasyczna w małopłytkowości samoistnej - porównanie kosztów i ocena wczesnych wyników. Pol Przegl Chir 2004; 6: 607-17.
  • Radaelli F, Faccini P, Goldaniga M et al.: Factors predicting response to splenectomy in adult patients with idiopathic thrombocytopenic purpura. Haematologica 2000; 85: 1040-44.
  • Fabris F, Tassan T, Ramon R et al.: Age as the major predictive factor of long-term response to splenectomy in immune thrombocytopenic purpura. Br J Haematol 2001; 112: 637-40.
  • Bourgeois E, Caulier MT, Delarozee C et al.: Longterm follow-up of chronic autoimmune thrombocytopenic purpura refractory to splenectomy: a prospective analysis. Br J Haematol 2003; 120: 1079-88.
  • Lamy T, Moisan A, Dauriac C et al.: Splenectomy in idiopathic thrombocytopenic purpura: its correlation with the sequestration of autologous indium-111-labeled platelets. J Nucl Med 1993; 34: 182-86.
  • Louwes H, Zeinali Lathori OA, Vellenga E et al.: Platelet kinetic studies in patients with idiopathic thrombocytopenic purpura. Am J Med 1999; 106: 430-34.
  • Rossi G, Cattaneo C, Motta M et al.: Platelet kinetic study in patients with idiopathic thrombocytopenic purpura (ITP) refractory or relapsing after corticosteroid treatment. Hematol J 2002; 3: 148-52.[Crossref]
  • Vecchio R, Cacciola E, Cacciola RR et al.: Predictive factors of response to splenectomy in adult chronic idiopathic thrombocytopenic purpura. Int Surg 2000; 85: 252-56.
  • Zoghlami-Rintelen C, Weltermann A, Bittermann C et al.: Efficacy and safety of splenectomy in adult chronic immune thrombocytopenia. Ann Hematol 2003; 82: 290-94.
  • Sikorska A: Małopłytkowość samoistna - przydatność diagnostyki immunologicznej oraz ocena przebiegu choroby i skuteczności leczenia. Rozprawa doktorska, Instytut Hematologii i Transfuzjologii. Warszawa 2002.
  • Portielje JE, Westendorp RG, Kluin-Nelemans HC et al.: Morbidity and mortality in adults with idiopathic thrombocytopenic purpura. Blood 2001; 97: 2549-54.
  • Jacobsen CT, Shurin S: Disorders of the Spleen. W: Blood: principles and practice of Hematology. Handin R, Lux SE, Stossel TP (red.). wyd. Lippincott Williams & Wilkins, Philadelphia 2003, 648-667.
  • Bolton-Maggs PH, Stevens RF, Dodd NJ et al.: General Haematology Task Force of the British Committee for Standards in Haematology. Guidelines for the diagnosis and management of hereditary spherocytosis. Br J Haematol 2004; 126: 455-74.
  • Bolton-Maggs PH: Hereditary spherocytosis; new guidelines. Arch Dis Child 2004; 89: 809-12.
  • Eber SW, Armbrust R, Schroter W: Variable clinical severity of hereditary spherocytosis: relation to erythrocytic spectrin concentration, osmotic fragility, and autohemolysis. J Pediatr 1990; 117: 409-16.
  • Diehl V, Re D, Josting A: Hodgkin's Disease: clinical manifestation, staging and therapy. Hematology: basic principles and practice. Hoffman R (red.). Elsevier Churchill Livingstone, Philadelphia 2005,1347-77.
  • Multani PS, Grossbard ML: Staging Laparotomy in the Management of Hodgkin's Disease: Is It Still Necessary? Oncologist 1996; 1: 41-55.
  • Allsup DJ, Cawley JC: Diagnosis, biology and treatment of hairy-cell leukaemia. Clin Exp Med 2004; 4: 132-38.[Crossref][PubMed]
  • Greyz N, Saven A: Cladribine: from the bench to the bedside - focus on hairy cell leukemia. Expert Rev Anticancer Ther 2004; 4: 745-57.[Crossref][PubMed]
  • Cervantes F, Pereira A, Esteve J et al.: The changing profile of idiopathic myelofibrosis: a comparison of the presenting features of patients diagnosed in two different decades. Eur J Haematol 1998; 60: 101.
  • Tefferi A, Mesa RA, Nagorney DM et al.: Splenectomy in myelofibrosis with myeloid metaplasia: a single-institution experience with 223 patients. Blood 2000; 95: 2226-33.
  • Barosi G, Ambrosetti A, Centra A et al.: Splenectomy and risk of blast transformation in myelofibrosis with myeloid metaplasia. Italian Cooperative Study Group on Myeloid with Myeloid Metaplasia. Blood 1998; 91: 3630-36.
  • Dingli D, Utz JP, Krowka MJ et al.: Unexplained pulmonary hypertension in chronic myeloproliferative disorders. Chest 2001; 120: 801-08.
Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_v10035-007-0066-y
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.