Splenectomy results from an 18-year single centre experience

Davies, I. Ll; J Cho; Lewis, M. H.
February 2014
Bulletin of The Royal College of Surgeons of England;Feb2014, Vol. 96 Issue 2, p147
INTRODUCTION Splenectomy is performed both as an emergency procedure following trauma and electively when indicated for haematological disease. Postsplenectomy patients receive immunotherapy vaccines and continuous antibiotic prophylaxis. Despite well documented concerns regarding complications and overwhelming postsplenectomy infection (OPSI) risk, there appears to be only a small amount of consistent data on long-term outcomes. The authors therefore present their postsplenectomy patient outcomes over an 18-year follow-up period. METHODS One hundred and five postsplenectomy patients operated on between 1991 and 2011 were identified from pathology codes and their case notes were reviewed. Eighty-eight patients (83.8%) were followed up for at least five years or until death. RESULTS Of the 105 splenectomy patients (58 were male), the median age was 54 years (range: 10-87 years) and the median survival was 80 months. Operative morbidity and mortality rates were 21.0% (n=22) and 8.6% (n=9) respectively. Thirty-seven patients (27 males) underwent an emergency splenectomy with a median age, operative morbidity and operative mortality of 51 years, 13.5% and 21.6% (n=8) respectively. This compares with 68 patients (35 males) undergoing an elective splenectomy with the same parameters respectively of 55 years, 25.0% and 1.5% (n=1). Excluding operative deaths, multivariate analysis revealed age (p=0.002) as the only significant and independent prognostic indicator. Immunotherapy and antibiotic prophylaxis rates for the emergency cohort were 92.6% and 88.9% respectively, compared with 90.2% and 93.4% for the elective cohort. At follow-up, no patients were readmitted with OPSI. CONCLUSIONS Over an 18-year period and a diverse indication for splenectomy, we have identified no evidence of OPSI. However, a significant operative mortality was associated with traumatic splenic rupture.


Related Articles

  • Role of disinfection as infection prophylaxis over the course of time -- anesthesia, intensive care and emergency medicine, pain therapy. Lingnau, Werner // GMS Krankenhaushygiene Interdisziplinaer;2007, Vol. 2, p1 

    It is alarming that anesthetists, just as in earlier years, have been shown to be the specialists with the poorest rate of compliance with simple, basis everyday rules of hygiene. Unfortunately, infection prophylaxis is something to which the physician ascribes importance only when he sees the...

  • Relapsing bloodstream infections during treatment of acute leukemia. Cattaneo, Chiara; Antoniazzi, Francesca; Tumbarello, Mario; Skert, Cristina; Borlenghi, Erika; Schieppati, Francesca; Cerqui, Elisa; Pagani, Chiara; Petullà, Marta; Re, Alessandro; Rossi, Giuseppe // Annals of Hematology;May2014, Vol. 93 Issue 5, p785 

    Acute leukemia (AL) patients may experience more than one episode of bloodstream infection (BSI) caused by the same pathogen during the entire chemotherapy program. In order to identify factors influencing BSI recurrence (R-BSI) during subsequent phases of treatment, we analyzed all BSIs...

  • CORRECTION.  // Journal of the American Dental Association (JADA);Nov2014, Vol. 145 Issue 11, p1111 

    A correction to the article "Patients Who Received Preoperative Antibiotics Showed Fewer Early Implant Failures" by Ben Balevi in the October 2014 issue is presented.

  • THE IMPORTANCE OF EARLY DIAGNOSIS IN TRAUMATIC PATIENTS - CASE PRESENTATION. Gocan, H.; Surd, A. // Jurnalul Pediatrului;Jul-Dec2011, Vol. 14 Issue 55/56, p59 

    Introduction. Injuries arising from car accidents are problems that require a quick and accurate diagnosis, and when they occur in pediatric patients it becomes more difficult. This is often because children are unable to show the exact location of pain and lack precise communication, but...

  • Pediatric splenectomy for hematological diseases: outcome analysis. Durakbasa, C. U.; Timur, C.; Sehiralti, V.; Mutus, M.; Tosyali, N.; Yoruk, A. // Pediatric Surgery International;Aug2006, Vol. 22 Issue 8, p635 

    The article presents an outcome analysis of pediatric splenectomy for hematological diseases. Study was conducted on 119 children who underwent elective splenectomy for various hematological diseases at the Department of Pediatric Hematology institution between 1993 and 2004. The operations were...

  • Laparoscopic Partial Splenectomy: Indications and results of a multicenter retrospective study. Héry, Géraldine; Becmeur, François; Méfat, Laure; Kalfa, David; Lutz, Patrick; Lutz, Laurence; Guys, Jean-Michel; Lagausie, Pascal // Surgical Endoscopy;Jan2008, Vol. 22 Issue 1, p45 

    Partial splenectomy (PS) in children is a surgical option in haematological diseases and focal splenic tumours. The aim of this study was to describe the feasibility and the results of laparoscopic partial splenectomy in children in these two indications by a multicentric retrospective study....

  • Antibiotic prophylaxis for transrectal prostate biopsy—a new strategy—authors' response. Antsupova, Valeria; Arpi, Magnus // Journal of Antimicrobial Chemotherapy (JAC);Mar2015, Vol. 70 Issue 3, p957 

    A response from the authors of the article "Antibiotic prophylaxis for transrectal prostate biopsy—a new strategy" in the 2014; 69 issue is presented.

  • Erratum.  // British Dental Journal;10/27/2012, Vol. 213 Issue 8, p384 

    A correction to the article "NICE guideline and current practice of antibiotic prophylaxis for high risk cardiac patients (HRCP) among dental trainers and trainees in the United Kingdom," is presented.

  • Editorial [ Sepsis: From the Bench to the Bedside ]. Salomao, R. // Endocrine, Metabolic & Immune Disorders - Drug Targets;Jun2006, Vol. 6 Issue 2, p125 

    Sepsis: From the Bench to the Bedside The term sepsis derives from the Greek sepsis, which means putrefaction. The pathogenesis and clinical manifestations of sepsis result from a complex interaction between the host and the infecting microorganism. Evolving at different stages of a continuum...


Read the Article


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

Try another library?
Sign out of this library

Other Topics