Research Day
OUTCOMES OF SPLENECTOMY ON HEMATOLOGIC AND NON-HEMATOLOGIC SPLENIC CONDITIONS
Document Type
Abstract
Date
2021
Abstract
Introduction: Splenectomy is an important surgical procedure for many splenic conditions. We hypothesized that 30-day post-splenectomy outcomes are different based on surgical indications for splenectomy.
Methods and Procedures: Using the ACS-NSQIP database (2017), patients who underwent splenectomy were identified. The outcomes examined included 30-day mortality, morbidity, readmission rates, and reoperation.
Results: A total of 703 patients, of which 370 were males (52.6%) underwent splenectomy. A laparoscopic approach (LS) was performed on 389 patients (55.3%). All trauma patients underwent open procedures (OS). Indications for splenectomy were ITP (198 patients, 28.2%), splenomegaly/hypersplenism (113 patients, 16.1%), splenic abscess/infarction, (91 patients,12.9%), leukemia/lymphoma (87 patients, 12.4%), and trauma (77 patients, 11.0%). The 30-day mortality was highest among patients with leukemia/lymphoma (10.3%), and trauma (5.2%). No mortality was noted in patients with hemolytic anemias or benign splenic lesions. The mortality rate was higher in the OS group compared to the LS (4.8% vs. 1.3%, p=0.006). Overall morbidity was higher in trauma (70%), splenic abscess/infarction (66%), leukemia/lymphoma (40%), or splenomegaly/ hypersplenism (40.2%). Overall morbidity was higher in OS vs. LS (57.6% vs. 20.1%, p <0.001). No difference in readmission rate or reoperations between various groups who underwent splenectomy was noted.
Conclusion: Overall, the 30-day mortality and morbidity after splenectomy were higher in patients with leukemia and lymphoma, trauma, and splenic abscess and infarction. Patients with leukemia/lymphoma may benefit from prehabilitation and careful procedural timing. LS was associated with lower morbidity and mortality; therefore, it should be attempted if feasible in all non-emergent conditions.