SUBTOTAL SPLENECTOMY FOR TREATMENT OF PATIENTS WITH MYELOFIBROSIS ANDMYELOID METAPLASIA

Idiopathic myelofibrosis is a chronic myeloproliferative disorder that may course with myeloid metaplasia involving several organs, Occasion ally, the spleen reaches giant proportions and must be withdrawn, Howe ver, this procedure is followed by greater morbidity and mortality, Pa rtial splenectomies, preserving the splenic pedicle, have been propose d in order to reduce postoperative complications, After an early posto perative improvement, some patients present symptomatic recurrence of their disease, This communication presents a new alternative for the t reatment of complicated myeloid metaplasia: subtotal splenectomy, pres erving the upper splenic pole supplied only by the splenogastric vesse ls, We performed this procedure in three patients, Their almost two ye ars postoperative follow-up and health improvement suggest that this o peration should be considered for the treatment of huge spleens due to myelofibrosis with myeloid metaplasia.