Patrick T Hangge1, William W Sheaffer2, Matthew Neville3, Nabil Wasif4, Richard J Gray5, Barbara A Pockaj6, Chee-Chee H Stucky7. 1. Division of Surgical Oncology, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address: hangge.patrick@mayo.edu. 2. Division of Surgical Oncology, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address: Sheaffer.william@mayo.edu. 3. Department of Biostatistics, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address: Neville.matthew@mayo.edu. 4. Division of Surgical Oncology, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address: Wasif.nabil@mayo.edu. 5. Division of Surgical Oncology, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address: Gray.richard@mayo.edu. 6. Division of Surgical Oncology, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address: Pockaj.barbara@mayo.edu. 7. Division of Surgical Oncology, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address: Stucky.chee-chee@mayo.edu.
Abstract
BACKGROUND: The purpose of this study was to describe the diagnostic value and therapeutic benefit of diagnostic splenectomy. METHODS: Retrospective review was performed of patients undergoing splenectomy with an unknown diagnosis (UD), a hematologic malignancy (HM) or idiopathic thrombocytopenic purpura. Surgical indications and postoperative outcomes were evaluated. RESULTS: 113 splenectomy patients were identified. Of the UD patients undergoing splenectomy, 46% (n = 16) received a definitive diagnosis postoperatively. A change in diagnosis occurred in 12% (n = 4) of HM patients. Complete symptom relief was observed more often in UD patients who received a definitive diagnosis after splenectomy 69% (n = 11), compared to the 47% (n = 9) who did not receive definitive diagnosis postoperatively. CONCLUSIONS: The diagnostic ability of splenectomy was 46% when the diagnosis was unknown preoperatively. Additionally, a majority of patients experienced relief of symptoms postoperatively. Splenectomy may be a useful diagnostic and therapeutic tool in select UD and HM patients.
BACKGROUND: The purpose of this study was to describe the diagnostic value and therapeutic benefit of diagnostic splenectomy. METHODS: Retrospective review was performed of patients undergoing splenectomy with an unknown diagnosis (UD), a hematologic malignancy (HM) or idiopathic thrombocytopenic purpura. Surgical indications and postoperative outcomes were evaluated. RESULTS: 113 splenectomy patients were identified. Of the UD patients undergoing splenectomy, 46% (n = 16) received a definitive diagnosis postoperatively. A change in diagnosis occurred in 12% (n = 4) of HM patients. Complete symptom relief was observed more often in UD patients who received a definitive diagnosis after splenectomy 69% (n = 11), compared to the 47% (n = 9) who did not receive definitive diagnosis postoperatively. CONCLUSIONS: The diagnostic ability of splenectomy was 46% when the diagnosis was unknown preoperatively. Additionally, a majority of patients experienced relief of symptoms postoperatively. Splenectomy may be a useful diagnostic and therapeutic tool in select UD and HM patients.
Authors: Robert Naples; Alexander Bertke; Aldo Fafaj; Samuel J Zolin; Jonah D Thomas; Clayton Petro; David Krpata; Ajita S Prabhu; Michael J Rosen; Steven Rosenblatt Journal: World J Surg Date: 2020-09 Impact factor: 3.352