Splenectomy in Haematology Indications,Results, and Complications in 41 Cases

The indications for, effect of, and immediate complications of splenectomy are reported on the basis of 41 patients followed for from 3 months to 3 years after the operation. There is a general indication for splenectomy in hereditary spherocytosis, but in other cases of haemolytic anaemia splenectomy appears to presuppose proof that the spleen is playing the main role in the erythrocyte sequestration. In chronic lymphatic leukaemia splenectomy may evidently be advised on the basis of fairly simple clinical findings: Disease activity that calls for treatment, e.g. weight loss, a tendency to sweating as well as anaemia, thrombocytopenia, combined with considerable splenomegaly as the predominant focus. The time of splenectomy should not be delayed as long as possible, as decisive items of risk appear to increase with the duration of the disease. For instance, pronounced splenomegaly gives rise to special problems, and long-lasting cytostatic and corticoid medication as well as progression of the basic disease will increase the incidence of postoperative complications. Haemorrhage from the splenic bed and infection, most often with a pulmonary focus, were recorded as the most common operative complications. Their incidence was particularly high in operations on patients having chronic lymphatic leukaemia.