The implications for patients undergoing splenectomy: postsurgery risk management

ations for patients undergoing splenectomy: postsurgery risk management Review (2423) Total Article Views Authors: Romano F, Garancini M, Ciravegna AL, Uggeri F, Degrate L, Maternini M, Uggeri F Published Date August 2011 Volume 2011:4 Pages 21 - 34 DOI: http://dx.doi.org/10.2147/OAS.S10156 Fabrizio Romano, Mattia Garancini, Arianna Libera Ciravegna, Fabio Uggeri, Luca Degrate, Matteo Maternini, Franco Uggeri Department of General Surgery (Chirurgia I), San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy Abstract: Splenectomy has been performed for a heterogeneous group of hematologic diseases with a therapeutic or diagnostic purpose or as part of the staging process in Hodgkin’s disease. Most patients undergoing therapeutic splenectomy are chronically ill with significant splenomegaly. This scenario can be associated with a high risk of postoperative morbidity and mortality due to the prolonged course of disease for patients with myelofibrosis; their susceptibility to infection, thrombosis, and hemorrhage; and the severe enlargement of their spleens. We have reviewed the main papers published about postoperative complications after splenectomy, analyzing the risk factors, prevention measures, and respective treatments. Great care must be taken in the management of patients presenting malignant diseases, splenomegaly, and hemostasis disorder. Moreover, despite the faster discharge that new surgical techniques now allow, close attention should be paid to symptoms reported by patients, in order to avoid potentially life-threatening complications such as portal vein thrombosis, pancreas injuries, and overwhelming postsplenectomy infection.