RESUMO
Objective@#To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA).@*Methods@#Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up.@*Results@#Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years.@*Conclusion@#The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.
RESUMO
Objective To summarize the experience in diagnosis and treatment of primary splenic neoplasm (PSN) to promote understanding of the disease. Methods The clinical data of all admitted patients with PSN treated in this hospital from February 1989 to February 2004 were retrospectively analyzed. Results A total of 63 patients were treated by surgery and pathologically confirmed as PSN. Twenty-one patients were treated by splenectomy alone. Twenty-seven patients underwent distal pancreatectomy and splenectomy. Fifteen patients received splenectomy combined with excision of tumor, the 5-year survival rate was 35.9%(15/42). Conclusion PSN should be diagnosed mainly according to clinical manifestations, image examination, and fine needle aspiration biopsy. CT and angiography play an important role in the identification of benign and malignant splenic mass. Early diagnosis, radical resection and comprehensive treatment are important for improving the prognosis of PSN.
