>Cirugía y Cirujanos
>Year 2007, Issue 3
Ruiz-Molina JM, Ochoa-Sánchez EP, López-Basave HN, Barrera-Franco JL, Crocifoglio-Vincenzo A, Medina-Castro JM
Open splenectomy: Ten-year experience in an oncological referral center
Cir Cir 2007; 75 (3)
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Background: Open splenectomy is a useful procedure for some diseases with splenomegaly › 1500 g. We undertook this study to evaluate open splenectomy morbidity and mortality at the Instituto Nacional de Cancerologia in Mexico City.
Methods: We reviewed the clinical files of patients with benign and malignant hematological diseases, as well as other diseases, who underwent splenectomy from 1994 to 2005.
Results: Twenty five patients with a mean age of 38.5 years were submitted for open splenectomy. Splenomegaly was found in 12 patients (48 %). The most frequent abdominal wall incision was transverse left subcostal (64 %). Average surgical time was 125 min, bleeding 485 ml, spleen weight 1553.6 g and mean size 15 ´ 11 ´ 12 cm. Mean hospital stay was 7.5 days. Eighteen patients (72 %) did not have immediate complications. One patient (4 %) developed surgical wound infection, two patients (8 %) had significant pain, three patients (12 %) had bleeding and one patient (4 %) developed intraabdominal fluid collection. Twenty one patients (84 %) did not have further complications. One patient (4 %) developed multiple organ failure, another patient (4 %) developed thrombocytopenia and another (4 %) developed severe pain. During an average 81-month follow-up we found 14 patients (56 %) asymptomatic, two patients (8 %) with documented tumoral activity (angiosarcoma and non-Hodgkin’s lymphoma) and one patient (4 %) developed a second neoplasm. Six patients (2 %) died due to underlying disease (chronic myeloid leukemia and lymphoma), one patient (4 %) with active disease (Hodgkin’s disease) and one patient (4 %) died due to other causes.
Conclusions: With a spleen › 1500 g, open surgery offers better visibility and, in fact, less morbidity and mortality.
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>Cirugía y Cirujanos
>Year 2007, Issue 3