The Incidence of Splenectomy Is Decreasing: Lessons Learned from Trauma Experience

Rose, Amy T.; Newman, Martin I.; Debelak, Jacob; Pinson, C. Wright; Morrin Jr., John A.; Harley, David D.; Chapman, William C.
May 2000
American Surgeon;May2000, Vol. 66 Issue 5, p481
Academic Journal
Over the past decade, splenic preservation has become a well-reported and accepted principle in trauma management. The reasons for splenic preservation may have influenced nontraumatic surgical management as well. To investigate the changing incidence and indications for splenectomy, we conducted a 10-year review of all splenectomies at our institution. During this time, between January 1, 1986, and December 31, 1995, 896 patients underwent splenectomy. Hospital charts and records were examined to determine the etiology and incidence of splenectomy. Indications were classified as: 1) trauma, i.e., performed for blunt or penetrating injury; 2) hematologic malignancy, i.e., therapy or staging of underlying leukemia, Hodgkin's lymphoma, or non-Hodgkin's lymphoma; 3) cytopenia, i.e., treatment of thrombocytopenia, anemia, or leukopenia; 4) iatrogenic, i.e., injury during another procedure; 5) incidental, i.e., required for adjacent organ resection; 6) portal hypertension, i.e., left-sided portal hypertension or during shunting procedure; 7) diagnostic, i.e., uncertainty excluding hematologic malignancy; or 8) other, i.e., miscellaneous indications. Trauma accounted for 41.5 per cent of all splenectomies during this time period, hematologic malignancy 15.4 per cent, cytopenia 15.6 per cent, incidental 12.3 per cent, iatrogenic 8.1 per cent, portal hypertension 2.3 per cent, diagnostic 2.0 per cent, and other 2.7 per cent. Comparing the first and second 5-year time periods, the following increases/decreases in average annual incidence were noted: splenectomy for all indications, -36.9 per cent; trauma, -32.9 per cent; hematologic malignancy, -51.4 per cent; cytopenia, 35.1 per cent; incidental, -35.9 per cent; iatrogenic, -30.2 per cent; diagnostic, +4.9 per cent, and other, -57 per cent. Traumatic injury to the spleen remains the most common indication for splenectomy, but the incidence has decreased dramatically over the past 10 years. Splenectomies for treatment ...


Related Articles

  • The peril of thrombosis after splenectomy. Kent, Tyler J. // Cortlandt Forum;11/25/97, Vol. 10 Issue 11, p116 

    Replies to an inquiry on the risk of thrombosis after splenectomy. Patients prone to develop thrombosis after splenectomy; Prophylaxis for patients with thrombosis.

  • Splenectomy increases the subsequent risk of systemic lupus erythematosus: a word of caution. Misra, Durga; Jain, Vikramraj; Negi, Vir // Rheumatology International;Feb2016, Vol. 36 Issue 2, p277 

    A letter to the editor is presented in response to the article "Splenectomy increases the subsequent risk of systemic lupus erythematosus: a word of caution."

  • Hand-Assisted Laparoscopic Surgery of Splenic Cysts. Losanoff, Julian E.; Richman, Bruce W.; Jones, James W. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Oct2003, Vol. 13 Issue 5, p339 

    Presents a letter to the editor in response to the article "Hand-Assisted Laparoscopic Splenectomy for a Huge Splenic Cyst: Operative Technique and Case Report," by H. Yano, T. Asaoka, T. Iwazawa, M. Kinuta, T. Monden and S. Okamoto.


    An abstract of the article "Comparative Long-Term Follow-Up Study of Different Spleen-Saving Methods in Respect of Hyposplenic-Asplenic States," by A. Balint and colleagues, published in an issue of the "European Surgical Research" journal is presented.

  • Supply meets demand: Hospital to tie critical paths, purchasing. Taylor, Kathryn S. // H&HN: Hospitals & Health Networks;10/5/93, Vol. 67 Issue 19, p72 

    Features the patient-centered care strategy of Vanderbilt University Medical Center. Decentralized service centers; Combination with critical path program; Focus of its Center for Patient Care Innovation; Benefits from decentralization of materials; Standardization of treatment approaches;...

  • Laparoscopic Splenectomy for Ruptured Spleen: Lessons Learned from a Case. Basso, Nicola; Silecchia, Gianfranco; Raparelli, Luigi; Pizzuto, Gennaro; Picconi, Tullio // Journal of Laparoendoscopic & Advanced Surgical Techniques;Apr2003, Vol. 13 Issue 2, p109 

    Splenic rupture is a frequent consequence of blunt abdominal trauma. When nonsurgical management is not indicated, splenic rupture is usually an emergency requiring surgery. Removal of the spleen (splenectomy) or alternative conservative procedures (splenorraphy, partial splenectomy, and...

  • Laparoscopic Splenectomy in Patients with Normal-Sized Spleens Versus Splenomegaly: Does Size Matter? Heniford, B. Todd; Park, Adrian; Walsh, R. Matthew; Kercher, Kent W.; Matthews, Brent D.; Frenette, Gary; Sing, Ronald F. // American Surgeon;Sep2001, Vol. 67 Issue 9, p854 

    Laparoscopic resection has become the standard means for removal of normal-sized spleens in many medical centers. The application of minimally invasive techniques in the setting of splenomegaly is less well defined and was previously considered a contraindication to the laparoscopic approach....

  • Collaborative care pathways proving to be big money savers. Bankhead, Charles // Urology Times;May96, Vol. 24 Issue 5, p14 

    Describes the collaborative care pathway implemented at the Vanderbilt University Medical Center in Nashville, Tennessee. Cost effectiveness of the collaborative care; Evolution of the managed care plans; Features of the plan; Use of the care pathway to radical cystectomy; Vanderbilt's...

  • Prostatectomy costs cut in half. Overmyer, Mac // Urology Times;Sep95, Vol. 23 Issue 9, p1 

    Reports on the development of a prostatectomy pathway that provides quality results at minimal cost. Collaborative-care approach used in the Vanderbilt University Medical Center in Nashville, Tennessee; Recognition of situations deviating from pathway.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics