Long term effect of splenectomy on patients operated on for cancer of the left colon: a retrospective study

Objective: To find out if accidental splenectomy during colonic resection i nfluences the survival of patients with colon cancer. Design: Retrospective clinical study. Setting: University hospital, Greece. Subjects: Twenty-five patients with colonic cancer (13 Dukes' B and 12 Duke s' C) who had accidental splenectomy during resection of the left colon (n = 22) or the sigmoid (n = 3) between 1973 and 1990. Each study patient was matched with control patients for age, sex, Dukes' stage, grade, site of tu mour, date, type of operation and number of blood transfusions. Main outcome measures: The five year actuarial and disease free survival es timated by the Kaplan-Meier product limit method. Results: There were significantly more infective postoperative complication s (6/25 compared with 0/25, p = 0.02) in patients who had a splenectomy. Th e incidence of metastases (p = 0.07) and the five-year disease free (p = 0. 08) and overall survival (p = 0.1) were lower but not significantly so in p atients who had a splenectomy compared with controls. Conclusions: Splenectomy significantly increases the number of infective po stoperative complications in patients with colonic cancer. Although there w as a trend for shorter disease-free survival after splenectomy, it seems th at splenectomy had no impact on survival.