[Thoracic approach for splenectomy in hematologic patients].

The article discusses the advantages of the thoracic approach in splenectomy in hematological patients. The high operative risk in patients with a marked hemorrhagic syndrome, and particularly, in the development of the Itsenko-Cushing's syndrome, is emphasized. An abdominal approach fails to ensure a safe operation in these patients. By means of topographoanatomical studies, analysis of the postoperative complications, and detailed investigation of the operative stages the authors prove the advantages of approaching the spleen through the thorax with diaphragmotomy. From experience with 226 operations for splenectomy in various diseases of the blood system, the authors showed that the number of postoperative surgical complications may be reduced by several times as compared to that in an abdominal approach.