Splenectomy for hematologic disorders: a 20 year experience.

A retrospective chart analysis was conducted for all patients undergoing splenectomy for hematologic disorders at the Baptist Hospitals of Louisville between 1970 and 1989. Fifty-nine charts comprise the basis of this review. Variables considered included disease entities treated by splenectomy, indications for splenectomy, and morbidity and mortality associated with the surgery. Additional variables evaluated were splenic weight, estimated blood loss at surgery, technique of splenectomy, and drainage of the splenic bed. The authors found a high correlation of splenic weight to the hematologic disorder treated. Larger spleens were associated with greater blood loss at surgery. Preliminary splenic artery ligation did not reduce the operative blood loss in patients with massive spleens. Drainage of the splenic bed was not associated with postoperative bleeding or intra-abdominal abscess. The low morbidity (22%) and mortality (3.4%) compares favorably to other published studies, demonstrating that splenectomy for hematologic disorders may be safely performed in the community hospital setting.