Indications of Splenectomy and Postoperative Mortality

DOI: 10.21276/sjams.2018.6.3.102 Abstract: The aim of this study was to investigate the risk factors for mortality by evaluating the indications for splenectomy and postoperative mortality in patients that underwent splenectomy over a 6-year period at a general surgery department. The retrospective study included 107 patients aged over 18 years that underwent splenectomy. The patients were divided into two groups: (I) surviving and (II) no surviving. Age, gender, hospital stay, surgical procedure (elective or emergency), type of surgery (open or laparoscopic), indications for splenectomy, and the histopathological diagnosis of the splenectomy specimen were recorded for each patient. The 107 patients comprised 58 (54.2%) men and 49 (45.8%) women. Of these, 94 (87.9%) patients were in the surviving group and 13 (12.1%) were in the no surviving group. Of the 107 patients, 66 (61.7%) underwent elective surgery and 41 (38.3%) underwent emergency surgery. Mortality occurred in 4 (6%) patients that underwent elective surgery and in 9 (22%) patients that underwent emergency surgery and the risk of mortality was significantly higher in the patients that underwent emergency surgery compared to elective surgery (p<0.05). The most common indication for splenectomy was trauma (n=35; 32.7%), followed by nondramatic hematological indications (n=30; 28%) including ITP (n=15; 14%), sickle cell anemia (n=9; 8.4%), beta thalassemia (n=5; 4.7%), and hereditary spherocytosis (n=1; 0.9%). In addition, splenectomy was performed as a component of the debunking of ovarian cancer (n=28; 26.2%). Complications occurred in 19 (12%) patients, with the most common complications including isolated abdominal bleeding (n=7; 6.5%) and isolated atelectasis and pneumonia (n=6; 5.6%). Trauma is the most common indication for splenectomy in general surgery practice and benign hematological disorders are also highly common among the indications for splenectomy. In addition, emergency splenectomy is a risk factor for mortality.