Evidence map›Paper›PMID 32939448›Full record

ArticleSurgery open science2020

Splenectomy for benign and malignant hematologic pathology: Modern morbidity, mortality, and long-term outcomes.

Wilson M Alobuia, Kenneth Perrone, David J Iberri, Rondeep S Brar, David A Spain, Joseph D Forrester

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Article in Surgery open science, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Wilson M AlobuiaDepartment of Surgery, Stanford University, Stanford, CA.
Kenneth PerroneDepartment of Surgery, Stanford University, Stanford, CA.
David J IberriDepartment of Medicine-Hematology, Stanford University, Stanford, CA.
Rondeep S BrarDepartment of Medicine-Hematology, Stanford University, Stanford, CA.
David A SpainDepartment of Surgery, Stanford University, Stanford, CA.
Joseph D ForresterDepartment of Surgery, Stanford University, Stanford, CA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of splenectomy to diagnose and treat hematologic disease continues to evolve. In this single-center retrospective review, we describe modern morbidity, mortality, and long-term outcomes associated with splenectomy for benign and malignant hematologic disorders.

methodsWe analyzed all nontrauma splenectomies performed for benign or malignant hematologic disorders from January 2009 to September 2018. Variables collected included demographics, preexisting comorbidities, laboratory results, intra- and postoperative features, and long-term follow-up. Outcomes of interest included postoperative complications, 30-day mortality, and overall mortality.

resultsWe identified 161 patients who underwent splenectomy for hematologic disorders. Median age was 54 years (range 19-94), and 83 (52%) were female. Splenectomy was performed for 95 (59%) patients with benign hematologic disorders and for 66 (41%) with malignant conditions. Most splenectomies were laparoscopic (76%), followed by laparoscopic hand assisted (11%), open (8%), and laparoscopic converted to open (6%). Median follow-up was 761 days (interquartile range: 179-2025 days). Major complications occurred in 21 (13%) patients. Three (2%) patients died within 30 days; 16 (9%) died more than 30 days after operation, none from surgical complications, with median time to death of 438 days (interquartile range: 231-1497 days). Among malignant cases, only preoperative thrombocytopenia predicted death (odds ratio = 5.8, 95% confidence interval = 1.1-31.8, P = .04). For benign cases, increasing age was associated with inferior survival (odds ratio = 2.3, 95% confidence interval = 1.0-5.1, P = .05).

conclusionSplenectomy remains an important diagnostic and therapeutic option for patients with benign and malignant hematologic disorders and can be performed with a low complication rate. Despite considerable burden of comorbid disease in these patients, early postoperative mortality was uncommon.

Identifiers

PMID32939448
PMCPMC7479208

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