Our Summary

This research paper is about the use of a surgical procedure called splenectomy, which involves removing the spleen, in treating blood-related diseases. In the past, this procedure was commonly used for managing such diseases. However, with the development of new medical treatments, the need for splenectomy has decreased.

To explore this trend, the researchers looked back at medical records of patients who had their spleens removed because of blood diseases between 2010 and 2023. They divided the patients into four groups based on their specific disease: autoimmune and hemolytic diseases, lymphomas, myeloproliferative diseases, and other spleen-related diseases.

Their findings showed that fewer patients were being recommended for splenectomy, especially those with autoimmune diseases. In fact, none of the patients diagnosed with a specific blood disorder called immune thrombocytopenic purpura were recommended for splenectomy despite an increase in the number of people diagnosed with this condition. A similar trend was observed for other two specific conditions: AHAI and Evans syndrome.

However, the number of spleen removals for treating lymphomas remained consistent over the study period. Also, only one patient with a large spleen due to a myeloproliferative disease was recommended for the procedure. Splenectomies for other reasons were equally spread out over the years.

In conclusion, the researchers observed a significant decrease in the use of splenectomy for treating blood diseases, particularly autoimmune diseases. Therefore, they advise surgeons to be aware of this change but also to ensure they can still perform this procedure safely and effectively when required.

FAQs

  1. What is the purpose of a splenectomy and how has its use changed over time?
  2. According to the research, which group of patients has seen the largest decrease in recommendations for splenectomy?
  3. Are there any blood diseases for which the number of splenectomies has remained consistent?

Doctor’s Tip

A helpful tip a doctor might tell a patient about splenectomy is to take precautions to prevent infections after the surgery, as the spleen plays a role in fighting infections. Patients should be vaccinated against certain infections, such as pneumonia and meningitis, both before and after the procedure. It is also important for patients to be vigilant about any signs of infection, such as fever, chills, and unusual fatigue, and seek medical attention promptly if any symptoms arise. Additionally, patients should avoid contact with individuals who are sick and practice good hygiene to reduce the risk of infection.

Suitable For

Typically, patients with autoimmune and hemolytic diseases, lymphomas, myeloproliferative diseases, and other spleen-related diseases are recommended for splenectomy. However, the use of splenectomy for treating autoimmune diseases has decreased significantly in recent years, with other treatment options becoming more prevalent. Patients with lymphomas may still be recommended for splenectomy, and in some cases, patients with myeloproliferative diseases or other spleen-related conditions may also undergo the procedure. Surgeons should be aware of this trend and ensure they can perform splenectomy safely and effectively when necessary.

Timeline

Before splenectomy:

  • Patient is diagnosed with a blood-related disease that may require splenectomy as a treatment option.
  • Patient undergoes various tests and evaluations to determine if splenectomy is the best course of action.
  • Patient discusses the risks and benefits of the procedure with their healthcare team.
  • Surgery is scheduled, and patient prepares for the operation by following pre-operative instructions.

After splenectomy:

  • Patient undergoes the surgical procedure to remove the spleen.
  • Patient is monitored closely in the hospital for any complications or side effects.
  • Patient may experience pain, discomfort, and fatigue as they recover from surgery.
  • Patient is discharged from the hospital and given instructions on post-operative care, including wound care and activity restrictions.
  • Patient follows up with their healthcare team for monitoring and management of any potential long-term effects of splenectomy, such as increased risk of infections.
  • Patient may need to receive vaccinations and take medications to prevent infections due to the absence of the spleen.
  • Patient may need to make lifestyle adjustments, such as avoiding certain activities or foods that increase the risk of infections.
  • Patient continues to have regular check-ups and follow-ups to monitor their health and well-being post-splenectomy.

What to Ask Your Doctor

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

  1. Why is splenectomy being recommended for my specific condition?
  2. What are the potential risks and complications associated with splenectomy?
  3. How will my immune system be affected after splenectomy?
  4. Are there alternative treatments available that do not involve removing the spleen?
  5. What is the recovery process like after splenectomy?
  6. Will I need to take any medications or make lifestyle changes after the procedure?
  7. How will my long-term health be impacted by having my spleen removed?
  8. Are there any restrictions on physical activity or travel after splenectomy?
  9. How often will I need follow-up appointments after the surgery?
  10. Can you provide me with information about the success rates of splenectomy for my specific condition?

Reference

Authors: Fernández-Ananin S, Novelli S, Cambeiro Cabré L, Vila Riera C, Ballester Vàzquez E, Julià Verdaguer E, Targarona EM. Journal: Surg Endosc. 2024 Nov;38(11):6332-6337. doi: 10.1007/s00464-024-11071-8. Epub 2024 Aug 29. PMID: 39210059