OBJECTIVE: To assess the effect of certain risk factors on the outcome of elective splenectomy. DESIGN: Retrospective cohort study. SETTING: University hospital, Norway. SUBJECTS: 135 patients who underwent elective splenectomy from 1978 to 1992 for autoimmune diseases (n = 58), myeloproliferative disorders (n = 58), and other diagnoses (n = 19). MAIN OUTCOME MEASURES: Morbidity and mortality, and the effect on outcome of age, malignancy, platelet count, treatment with steroids, and blood transfusion during the operative period. RESULTS: Three patients died, one from each diagnostic group; all had been treated with steroids. The overall complication rate was 31% (42/135). Most of the complications (31, 74%) were infective (pneumonia n = 23, abscess or sepsis n = 8). Nine patients required reoperation (haemorrhage, n = 6, and wound dehiscence, n = 2, and bowel obstruction, n = 1). Neither treatment with steroids nor severe thrombocytopaenia were risk factors for any complication, but age (p = 0.05) and a diagnosis of myeloproliferative disease (p = 0.08) had an important though not significant role. Blood transfusion during the operative period was the only independent risk factor (p = 0.001), and further analysis showed that transfusion of blood had a dose dependent effect on the incidence of infective complications (chi-square for linear trend 14.21 p < 0.001). CONCLUSION: To reduce the complication rate of elective splenectomy blood transfusion during the operative period should be avoided.
OBJECTIVE: To assess the effect of certain risk factors on the outcome of elective splenectomy. DESIGN: Retrospective cohort study. SETTING: University hospital, Norway. SUBJECTS: 135 patients who underwent elective splenectomy from 1978 to 1992 for autoimmune diseases (n = 58), myeloproliferative disorders (n = 58), and other diagnoses (n = 19). MAIN OUTCOME MEASURES: Morbidity and mortality, and the effect on outcome of age, malignancy, platelet count, treatment with steroids, and blood transfusion during the operative period. RESULTS: Three patients died, one from each diagnostic group; all had been treated with steroids. The overall complication rate was 31% (42/135). Most of the complications (31, 74%) were infective (pneumonia n = 23, abscess or sepsis n = 8). Nine patients required reoperation (haemorrhage, n = 6, and wound dehiscence, n = 2, and bowel obstruction, n = 1). Neither treatment with steroids nor severe thrombocytopaenia were risk factors for any complication, but age (p = 0.05) and a diagnosis of myeloproliferative disease (p = 0.08) had an important though not significant role. Blood transfusion during the operative period was the only independent risk factor (p = 0.001), and further analysis showed that transfusion of blood had a dose dependent effect on the incidence of infective complications (chi-square for linear trend 14.21 p < 0.001). CONCLUSION: To reduce the complication rate of elective splenectomy blood transfusion during the operative period should be avoided.
Authors: C Balagué; S Vela; E M Targarona; I J Gich; E Muñiz; A D'Ambra; A Pey; V Monllau; E Ascaso; C Martinez; J Garriga; M Trias Journal: Surg Endosc Date: 2006-07-24 Impact factor: 4.584
Authors: C Balagué; E M Targarona; G Cerdán; J Novell; O Montero; G Bendahan; A García; A Pey; S Vela; M Diaz; M Trías Journal: Surg Endosc Date: 2004-06-23 Impact factor: 4.584
Authors: Edward P Dominguez; Yong U Choi; Bradford G Scott; Alan M Yahanda; Edward A Graviss; John F Sweeney Journal: Surg Endosc Date: 2006-11-14 Impact factor: 3.453