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A Journal on Surgery

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Chirurgia 1999 October;12(5):333-8

language: Italian

Splenectomy: indications and surgical techniques

Porzio S., Marocco M., Listorti N., Lombardi V., Scotti A., Porzio R.

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Background. Splenectomy has undergone remarkable changes both for indications and surgical techniques. This is mainly due to a correct evaluation of the course of many hematological illnesses, to a better acquaintance of the anatomy of the spleen, with identification of splenic segments with functional autonomy, and the value of new surgical techniques.
Methods. 442 patients who underwent surgery between January 1980 and June 1998 (256 male, 57,9% and 186 females, 42,1%), are studied. The many indications to splenectomy are grouped in relation to the various diseases: primarily trauma (32,4%), followed by hematological congenital diseases (29%), non neoplastic splenomegalies (20,5%), lymphoma splenomegalies (9%), diseases of organs surrounding the spleen (7%) and finally cystic and solid neoplasms (2,1%). The surgical access was a median laparotomy in emergencies and left subcostal incision in elective settings.
Results. Surgical procedure was a success in emergency cases and for some hematological patients.
Conclusions. Some surgical techniques are reported and it is underlined that one of the first surgical acts should be splenic artery tying, in order to avoid blood transfusions in the elective setting and a useless loss of blood in emergencies.

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