Splenectomy in Hematologic Diseases

The effect of splenectomy in a variety of hematological disorders has been evaluated by a follow‐up study of 179 patients 3–15 years after surgery. A lasting remission was obtained in about 75% of patients with idiopathic thrombocytopenic purpura. All patients with hereditary spherocytosis had a complete remission, whereas hereditary non‐spherocytic hemolytic anemia was not influenced by splenectomy. More than 50% of patients with acquired hemolytic anemia showed no symptoms of hemolytic disease when examined ten years after surgery. Twenty‐five % of the patients with pancytopenia were in good condition ten years after splenectomy. Normal or increased bone marrow cellularity in this condition strengthens the indication for surgery. The proliferative diseases including chronic lymphatic leukemia, lymphosarcoma and myelofibrosis may represent indications for surgery whereas chronic myelogenous leukemia seemed to be a contraindication for splenectomy. The hematological disturbances associated with congestive splenomegaly usually can be corrected by splenectomy.