Elective splenectomy for hematological diseases : a vanishing indication
Fernández-Ananín, Sonia (Institut de Recerca Sant Pau)
Novelli, Silvana (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Cambeiro Cabré, Lorena (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Vila Riera, Cecilia (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Ballester Vázquez, Eulàlia (Institut de Recerca Sant Pau)
Julia Verdaguer, Elisabet (Institut de Recerca Sant Pau)
Targarona, Eduardo M. (Institut de Recerca Sant Pau)

Fecha:	2024
Resumen:	Introduction: Splenectomy has been used as a diagnostic and therapeutic tool in the management of hematological diseases for many years. However, the emergence of new medical therapies has modified guidelines for many hematological diseases for which splenectomy was previously considered. We aimed to evaluate the evidence of a decrease in the hematological indications for splenectomy and the reasons and justifications for this change. Material and methods: We conducted a single-center, retrospective analysis of patients who underwent laparoscopic splenectomy for hematological disease between January 2010 and December 2023. Patients were classified into four groups: 1 autoimmune and hemolytic diseases (HAD), (2) lymphomas, (3) myeloproliferative diseases (MPN), and (4) other splenic diseases. We recorded the annual incidence of splenectomy and the ratio of new medical cases, demographic and clinical data and surgical outcomes. Results: During the study period, 98 patients were referred for splenectomy. There was a significant progressive decrease in this surgical indication, particularly regarding HAD (p < 0. 001). The indication for splenectomy for immune thrombocytopenic purpura (ITP) declined to zero despite an increase in the number of patients diagnosed with this disorder (p < 0. 001). The pattern of decrease in AHAI and Evans syndrome was similar to that in ITP. The group of splenectomies due to lymphoma persisted consistently during the study period, as did the indication for splenectomy in the context of lymphoma treatment. Splenectomy due to massive splenomegaly secondary to MPN was indicated only in one patient. Splenectomies due to other causes were similarly distributed over the years. Conclusions: Our findings confirm a significant decrease in the indication for elective surgery for hematological diseases, mainly regarding autoimmune disease. The surgical community and surgical departments should be aware of this situation yet maintain the skills to adopt this technique both safely and efficiently.
Nota:	Altres ajuts: acords transformatius de la UAB
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Laparoscopic splenectomy ; Hematological diseases ; Autoimmune diseases ; Medical therapies ; Immune thrombocytopenic purpura
Publicado en:	Surgical endoscopy and other interventional techniques, Vol. 38, Num. 11 (November 2024) , p. 6332-6337, ISSN 1432-2218

DOI: 10.1007/s00464-024-11071-8
PMID: 39210059

6 p, 738.1 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Recerca Sant Pau
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