Removal of the massive spleen: a surgical risk?

The results of splenectomy for hematologic disorders have been reviewed with special attention to problems possibly associated with massive spleens (1,500 g or more). The mortality rate in the group of patients with massive spleens did not differ from that in the group of patients with smaller spleens (2 percent and 3 percent, respectively). The complication rate, however, in the group of patients with massive spleens (43 percent) was twice that in the patients with smaller spleens (43 percent and 22 percent, respectively). The most frequent complication was postoperative hemorrhage in the splenic bed, usually caused by thrombocytopenia, perisplenitis , or both. Postoperative morbidity is seen as a function of the underlying disorder and of the general condition of the patient and not of the weight of the spleen per se.