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South African Medical Journal

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The Place of Splenectomy in Haematological Disorders

D Gale, P Sacks, S Lynch, TH Bothwell, W Bezwoda, K Stevens

Abstract


The results of 67 consecutive splenectomies carried out in patients attending the Haematology Clinic at the Johannesburg Hospital between 1965 and 1972 are reported. Forty patients underwent splenectomy because of the presence of cytopenia due in part at least to hypersplenism. The best results were achieved in 21 patients who were considered to have cytopenia due to a disordered immune mechanism and in whom the  spleen was usually normal in size or only minimally enlarged. In addition, satisfactory results were obtained in 17 patients with a large spleen and pancytopenia. In this group the least satisfactory results were recorded in patients with advanced myelofibrosis. The results of splenectomy were also disappointing in 9 patients with lymphoma and other haematological malignancies. Sixteen diagnostic splenectomies were performed: 11 were done as part of a 'staging' laparotomy, for lymphoma. Although there was no operative mortality in this study, half the patients suffered complications, and in 16% of them they were severe, being usually the result of haemorrhage and/or infection.

S. Air. Med. J., 48, 1240 (1974).



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