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Elective splenectomy in the elderly - perioperative and long-term course

Pålsson, Birger LU ; Hallén, Magnus LU ; Nordenström, Erik and Andersson, Roland LU (2001) In Langenbeck's Archives of Surgery 386(5). p.339-345
Abstract
Background: The hazards of elective splenectomy in the elderly have not been thoroughly investigated. The aim was to assess such a well-defined cohort with respect to perioperative and long-term outcome. Methods: Fifty-two consecutively splenectomised patients during the period 1971-1995, aged 65 years or older, were followed until death (44 cases) or the end of 1999 (8 cases). Results: No intraoperative deaths occurred, while three patients (5.8%) died postoperatively in the 1970s. Twenty-four patients suffered from thirty-four postoperative complications, dominated by infections and haematomas. No differences were seen comparing patients with and without complications related to the American Society of Anesthesiologists' classes, total... (More)
Background: The hazards of elective splenectomy in the elderly have not been thoroughly investigated. The aim was to assess such a well-defined cohort with respect to perioperative and long-term outcome. Methods: Fifty-two consecutively splenectomised patients during the period 1971-1995, aged 65 years or older, were followed until death (44 cases) or the end of 1999 (8 cases). Results: No intraoperative deaths occurred, while three patients (5.8%) died postoperatively in the 1970s. Twenty-four patients suffered from thirty-four postoperative complications, dominated by infections and haematomas. No differences were seen comparing patients with and without complications related to the American Society of Anesthesiologists' classes, total transfusion rate, steroid medication, preoperative risk diseases, "giant spleens" or the time period during which the operations were performed. In 69% of the patients, the splenectomy was beneficial. During the long-term followup, 25 patients suffered from 59 infectious and thromboembolic episodes and 1 surgical complication. The dominating causes of death were the primary disease (29%), myocardial infarction (20%), sepsis (12%) and cerebrovascular lesions (12%), i.e. not directly related to late effects of the operation. Conclusion: Highrisk patients older than 65 years with haematological disorders can safely undergo splenectomy with a low mortality rate and a reasonable rate of morbidity. The long-term course demonstrates a fair response rate, minimal surgically related complications, but thromboembolic and infectious events, and the majority of deaths unrelated to late effects of the splenectomy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Splenectomy, Elderly, Haematological, Morbidity, Mortality, Long-term course
in
Langenbeck's Archives of Surgery
volume
386
issue
5
pages
339 - 345
publisher
Springer
external identifiers
  • wos:000171275700006
  • scopus:0034855241
ISSN
1435-2451
DOI
10.1007/s004230100244
language
English
LU publication?
yes
id
d07fb871-712e-4492-b361-cf6be4036631 (old id 1118854)
date added to LUP
2008-07-09 10:12:04
date last changed
2018-10-03 11:43:48
@article{d07fb871-712e-4492-b361-cf6be4036631,
  abstract     = {Background: The hazards of elective splenectomy in the elderly have not been thoroughly investigated. The aim was to assess such a well-defined cohort with respect to perioperative and long-term outcome. Methods: Fifty-two consecutively splenectomised patients during the period 1971-1995, aged 65 years or older, were followed until death (44 cases) or the end of 1999 (8 cases). Results: No intraoperative deaths occurred, while three patients (5.8%) died postoperatively in the 1970s. Twenty-four patients suffered from thirty-four postoperative complications, dominated by infections and haematomas. No differences were seen comparing patients with and without complications related to the American Society of Anesthesiologists' classes, total transfusion rate, steroid medication, preoperative risk diseases, "giant spleens" or the time period during which the operations were performed. In 69% of the patients, the splenectomy was beneficial. During the long-term followup, 25 patients suffered from 59 infectious and thromboembolic episodes and 1 surgical complication. The dominating causes of death were the primary disease (29%), myocardial infarction (20%), sepsis (12%) and cerebrovascular lesions (12%), i.e. not directly related to late effects of the operation. Conclusion: Highrisk patients older than 65 years with haematological disorders can safely undergo splenectomy with a low mortality rate and a reasonable rate of morbidity. The long-term course demonstrates a fair response rate, minimal surgically related complications, but thromboembolic and infectious events, and the majority of deaths unrelated to late effects of the splenectomy.},
  author       = {Pålsson, Birger and Hallén, Magnus and Nordenström, Erik and Andersson, Roland},
  issn         = {1435-2451},
  keyword      = {Splenectomy,Elderly,Haematological,Morbidity,Mortality,Long-term course},
  language     = {eng},
  number       = {5},
  pages        = {339--345},
  publisher    = {Springer},
  series       = {Langenbeck's Archives of Surgery},
  title        = {Elective splenectomy in the elderly - perioperative and long-term course},
  url          = {http://dx.doi.org/10.1007/s004230100244},
  volume       = {386},
  year         = {2001},
}