Van Tıp Dergisi (Oct 2019)

204 Splenektomi Olgusunun Analizi; Splenektomi Endikasyonları Değişiyor Mu?

  • Necat Almalı,
  • Özkan Yılmaz

DOI
https://doi.org/10.5505/vtd.2019.39259
Journal volume & issue
Vol. 26, no. 4
pp. 520 – 525

Abstract

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INTRODUCTION: Comprehension of the role of spleen in immune processes and definition of laparoscopic splenectomy have led to narrowing of indications of splenectomy, preferring spleen-sparing surgical approaches if splenectomy will be performed for indications other than hematological ones, and increased performing of laparoscopic splenectomy in particularly for hematological diseases. METHODS: 204 splenectomy cases performed between 2010-2017 at the YYU General Surgery Department have been retrospectively studied with attention paid to indications and surgical techniques. RESULTS: Splenectomy was performed for 38 cases due to trauma, 58 cases due to hematological diseases, out of a total of 312 gastric cancer surgery cases, 47 combined with gastrectomy and 23 combined with surgery for other abdominal malignancies, 8 cases due to hydatid cyst, 6 cases due to abscess, 9 cases due to spontaneous splenic hemorrhage, 6 cases due to massive splenomegaly, 4 cases due to migratory spleen. Out of 58 hematological cases, open splenectomy was performed for 8 cases due to large spleen size, laparoscopic splenectomy was performed for 46 cases and 4 cases were laparoscopic surgery that later converted to open splenectomy. For cases with other indications open splenectomy was performed for 143 cases and laparoscopic for 3 cases. DISCUSSION AND CONCLUSION: Because conservation remains at the forefront of the traumatic splenic lacerations, the most common indications of splenectomy; this group has composed 18,6% of the presented 204 cases, hematological splenectomies and splenectomies combined with adjacent organ malignancy surgeries are with increasing numbers and predominantly performed by laparoscopic method.

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