Our Summary

The study examines the removal of the spleen (splenectomy) in patients over 65 years of age. The researchers analyzed data from their clinic over 11 years, considering factors like the reason for surgery, the nature of any injury, the patient’s other health issues, how long they stayed in the hospital, and any complications or deaths. They found that out of 269 splenectomies, only 57 were performed on patients over 65. For this older group, the spleen was rarely removed due to injury. Instead, it was more often removed due to problems like infection, rupture, or issues with another organ. The study found that nearly 30% of these older patients died and about 58% experienced complications. However, the reasons for the surgery and the patient’s other health issues were significant factors. On average, these patients stayed in the hospital for over 20 days. The researchers concluded that spleen removal in patients over 65 has a high risk of complications and death. However, older patients who had their spleen removed due to a single injury or as a planned surgery had a better outlook.

FAQs

  1. What were the most common reasons for spleen removal in patients over 65 according to the study?
  2. What was the mortality and complication rate for patients over 65 who underwent a splenectomy?
  3. How long did patients over 65 typically stay in the hospital after a splenectomy?

Doctor’s Tip

A doctor might tell a patient considering splenectomy that while the procedure can be necessary in certain cases, it is important to weigh the risks and benefits, especially for older patients. They may advise the patient to discuss their individual situation, including the reason for surgery and any other health issues, in order to make an informed decision. Additionally, the doctor may recommend close monitoring after the surgery to watch for any complications and ensure proper recovery.

Suitable For

Patients who are typically recommended for splenectomy include those with:

  1. Severe trauma or injury to the spleen, such as from a car accident or other blunt force trauma
  2. Severe infections of the spleen, such as from a bacterial infection like sepsis
  3. Ruptured spleen, which can be life-threatening and require immediate removal
  4. Blood disorders, such as sickle cell disease or thalassemia, that affect the spleen’s function
  5. Certain cancers, such as lymphoma or leukemia, that involve the spleen
  6. Autoimmune disorders, such as autoimmune hemolytic anemia or immune thrombocytopenia, that affect the spleen’s function
  7. Enlarged spleen (splenomegaly) that is causing symptoms or complications

It is important for patients and their healthcare providers to carefully weigh the risks and benefits of splenectomy, especially in older patients, to ensure the best possible outcome.

Timeline

Before splenectomy:

  • Patient presents with symptoms such as infection, rupture, or issues with another organ
  • Patient undergoes diagnostic tests to determine the need for splenectomy
  • Surgery is scheduled and patient is prepped for the procedure

After splenectomy:

  • Patient undergoes surgery to remove the spleen
  • Patient is monitored in the hospital for complications
  • Patient may experience pain, fatigue, and weakness post-surgery
  • Patient is at risk for infections, particularly from encapsulated bacteria
  • Patient may need to take antibiotics and receive vaccinations to prevent infections
  • Patient may need to make lifestyle changes to reduce the risk of infections
  • Long-term follow-up care is necessary to monitor for any complications or changes in health

What to Ask Your Doctor

Some questions a patient should ask their doctor about splenectomy include:

  1. Why do I need a splenectomy?
  2. What are the risks and benefits of splenectomy for my specific situation?
  3. What other treatment options are available for my condition?
  4. How will my overall health and other medical conditions impact the success of the surgery?
  5. How long will I need to stay in the hospital after the surgery?
  6. What are the potential complications of splenectomy and how likely are they to occur?
  7. How will my immune system be affected by having my spleen removed?
  8. Will I need any special vaccinations or medications after the surgery?
  9. What is the long-term outlook for someone my age after undergoing a splenectomy?
  10. Are there any lifestyle changes I should make after the surgery to protect my health?

Reference

Authors: Doležal J, Vodička J, Šimánek V, Šmíd D, Třeška V. Journal: Rozhl Chir. 2018 Winter;97(12):546-550. PMID: 30646733