Research Day
OUTCOMES OF OPEN AND LAPAROSCOPIC APPROACH TO SPLENECTOMY ON HEMATOLOGIC DISORDERS
Document Type
Abstract
Date
2021
Abstract
Introduction: Splenectomy plays therapeutic and palliative role in some hematologic disorders. This study aims to evaluate the outcomes of laparoscopic (LS) and open splenectomy (OS) in the management of 3 hematologic disorders including; Idiopathic thrombocytopenic purpura (ITP), hemolytic anemias (HA), and Leukemia/Lymphoma (LL).
Methods and Procedures: Using a large national, ACS-NSQIP database (2017), patients who underwent splenectomy for ITP, HA, and LL, were identified. The outcomes examined included 30-day mortality, morbidity, readmission rates, and reoperation.
Results: A total of 343 patients, 190 were females (55.4%), underwent splenectomy. Indications for splenectomy were ITP (198 patients, 57.7%), HA (58 patients, 16.9%), and LL (87 patients, 25.4%).LS was performed on 263 patients [(174 (88%) of ITP, 47 (81%) HA, and only in 42 (48.3%) LL]. The 30-day mortality were 10.3% in LL, and 1% in ITP. No mortality was noted in patients with HA. Overall morbidity was higher in patients who underwent splenectomy for leukemia and lymphoma (40.2%), hemolytic anemia (34.5%)., and ITP (15.2%). Overall morbidity was higher in OS vs. LS (57.6% vs.20.1%, p <0.001). No difference in readmission rate or reoperations between the three groups (ITP, HA, LL). The mortality rate was higher in the OS compared to the LS (7.5% vs. 1.9%, p=0.013).
Conclusion: Overall, the 30-day mortality and morbidity were higher in patients after palliative splenectomy. No mortality in patients with HA. LS was associated with lower morbidity and mortality; therefore, it should be attempted in patients with ITP, HA, LL, for both therapeutic and palliative indications.