[Splenectomy in immune thrombocytopenia and other hematological diseases]

Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

[Splenectomy in immune thrombocytopenia and other hematological diseases]

G Chir. 1999 Nov-Dec;20(11-12):479-86. Unique Identifier : AIDSLINE MED/20109414
Lanzi S; Lancini GP; Piardi T; Biasca F; Ottaviani GM; Rossi G; Pizzoccaro C; Pouche A; Cattedra di Semeiotica Chirurgica, Universita degli Studi di; Brescia.

Abstract: The Authors report a retrospective study of 74 splenectomies performed for hematologic diseases. The role of splenectomy has changed over recent years with increased indications for immune thrombocytopenic purpura (ITP). The aim of this study was to assess indications to surgery in relation to clinical presentation with typical hemorrhagic features or severe thrombocytopenia only; interval between onset of symptoms and splenectomy; failure of medical management and complications from steroid administration; scintigraphic studies predictive of response to splenectomy and preoperative treatment in patients with severe thrombocytopenia were also studied. The Authors reported response rates to splenectomy of 84% without mortality and only 11% of postoperative complications. These results encouraged to surgery for treatment of those patients with severe thrombocytopenia, who fail to obtain remission or develop serious complications after medical therapy. The splenectomy cured severe thrombocytopenia also in some patients with acquired immunodeficiency (HIV+). Moreover the Authors discuss the indications in patients with chronic lymphatic leukaemia and lymphoma diseases. In selected patients the splenectomy has the potential to relieve symptoms due to splenomegaly, correct cytopenias, specify hystological diagnosis and modify the disease course of malignant lymphomas. In fact splenomegaly sometimes complicated the course of malignant lymphomas because of hematologic abnormalities that are inconsistent with active chemotherapy.

Keywords: JOURNAL ARTICLE ematologiche. Acquired Immunodeficiency Syndrome/COMPLICATIONS Adrenal Cortex Hormones/THERAPEUTIC USE Adult Aged Comparative Study English Abstract Female Hematologic Diseases/*SURGERY Human Immunoglobulins, Intravenous/THERAPEUTIC USE Immunologic Deficiency Syndromes/CONGENITAL Immunosuppressive Agents/THERAPEUTIC USE Leukemia/SURGERY Lymphoma/SURGERY Lymphoma, Non-Hodgkin/SURGERY Male Middle Age Myelofibrosis/SURGERY Platelet Count Purpura, Thrombocytopenic, Idiopathic/COMPLICATIONS/*SURGERY/ THERAPY Retrospective Studies *Splenectomy Splenomegaly/ETIOLOGY/SURGERY

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