Removal of huge spleen: a surgical risk? its morbidity and mortality

ABSTRACT

Reports vary about whether risks are greater for removal of huge [>1500g] spleens than for smaller [<1500g] spleens. Splenectomy was performed on 196 patients presented with massive splenomegaly [n=83] and smaller splenomegaly [n=113]. Patients with huge spleens are no more likely to have postoperative complications [relative risk [RR] 2.2 95% confidence interval [Cl] 1.5 to3.1; p=0.7] and death [RR, 4, 3; 95% Cl, 1.4 to 12.2; p=0.3]. When the investigation is restricted to comparable diagnoses [congestive splenomegaly], patients with huge spleens do not differ from those with smaller spleens regarding complications [RR 1.3; 95% Cl 0.9 to 2.8; p=0.2] and death [RR2.1; Cl 0.9 to 8.2; p=0.3]. Multivariate analysis accused age as a critical risk of complications and death. This series concluded that increased age and underlying illness are the predominant factors associated with morbidity and mortality following splenectomy for congestive and hematological massive splenomegally. Adjusting for age and diagnosis, spleen size is not a hazard