INDICATIONS FOR AND RESULTS OF SPLENECTOMY IN DIFFERENT HEMATOLOGICALDISORDERS

The objective of this retrospective study was to determine the indicat ions for splenectomy in hematological disorders and to analyze the res ults depending on the indication leading to surgery. Fifty-six patient s with various hematological disorders were splenectomized between 199 0 and 1994. The main indication was noted. Operative success was defin ed as: return to normal platelet counts without further medication in thrombocytopenia, relief of pain and local compression syndrome in pai nful splenomegaly, hemoglobin levels >10 g/dl without the need for fur ther transfusions in hemolytic anemia, response to chemotherapy after splenectomy for prior resistance because of massive splenic infiltrat ion, and relief of infection in splenic infection. Morbidity and morta lity were noted. Five major indications for splenectomy were found: th rombocytopenia (n=36, success 78%), painful splenomegaly (n=8, success 100%), hemolytic anemia (n=5, success 60%), resistance to chemotherap y because of massive splenic infiltration (n=5, success 40%), and sple nic infection after chemotherapy (n=2, success 100%). One patient with thrombocytopenia died (mortality 2%). Seven patients had major compli cations (13%). In hematological diseases, thrombocytopenia, painful sp lenomegaly and splenic infection are likely to be improved by splenect omy. In hemolytic anemia it can be a helpful approach, while in resist ance to chemotherapy because of massive splenic infiltration success i s less likely.