Spleen Diseases

The spleen is an organ located in the upper left abdomen, next to the stomach. It plays key roles in filtering old blood cells, producing antibodies for immune defense, and storing blood cells. Surgical removal of the spleen, known as splenectomy, may be necessary in cases of trauma, cancer, blood disorders, or severe infections. However, splenectomy carries risks, including increased susceptibility to infections.

What is the Spleen?

Splenectomy, or spleen surgery, may be necessary in various medical conditions:

1. Blood Diseases: Conditions like sickle cell anemia, autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura (ITP), and polycythemia vera may require splenectomy if other treatments fail to provide relief.

2. Cancer Diseases: Certain cancers, including lymphomas like Hodgkin Lymphoma and Non-Hodgkin Lymphoma, as well as chronic lymphocytic leukemia (CLL) and Hairy Cell Leukemia, may necessitate splenectomy, particularly if the cancer affects the spleen directly or spreads to it.

3. Splenomegaly (Spleen Enlargement): When the spleen becomes enlarged, causing symptoms such as abdominal pain and early satiety despite eating small amounts, splenectomy may be considered.

4. Hypersplenism: Conditions leading to excessive destruction of blood cells, such as cirrhosis, hepatitis, amyloidosis, sarcoidosis, and certain collagen tissue diseases, can result in hypersplenism. Splenectomy may be recommended if complications like anemia, thrombocytopenia, and leukopenia occur.

5. Infections: In cases of severe spleen infections or abscess formation that do not respond to antibiotics or other treatments, splenectomy may be necessary to address the infection.

These are some of the situations where splenectomy may be indicated, but the decision to undergo spleen surgery is made on a case-by-case basis after careful consideration of the individual's medical condition and overall health.

In what cases is spleen surgery (splenectomy) necessary?

Assoc. Dr. Mutlu Ünver graduated from Ege University Faculty of Medicine. Mutlu Ünver, who completed his specialty training at Ege University Faculty of Medicine, Department of General Surgery, serves his patients in his own clinic.

Assoc. Prof.

Mutlu Unver

Types of Splenectomy

Open splenectomy is a surgical procedure similar to laparoscopic splenectomy but with a longer incision. This approach is typically chosen for patients with significantly enlarged spleens that cannot be easily removed through the small incisions used in laparoscopic surgery. Additionally, open splenectomy may be preferred in cases of severe spleen injuries where rapid intervention is necessary to control bleeding and address other complications effectively. While open splenectomy involves a larger incision and longer recovery period compared to laparoscopic surgery, it allows surgeons greater access and visibility to perform the necessary procedures safely and efficiently.

Open Splenectomy

Complications associated with splenectomy, the surgical removal of the spleen, include:

Bleeding: The spleen's rich blood supply makes it susceptible to bleeding during surgery, especially in cases of illness or trauma. Identifying and controlling bleeding can be challenging during the procedure.
Injury to Adjacent Organs: The spleen is located near other organs in the abdomen, such as the stomach, diaphragm, and intestines. There is a risk of inadvertently injuring these neighboring structures during the surgical removal of the spleen.
Increased Risk of Infection: The spleen plays a crucial role in the body's immune system, particularly in fighting certain types of infections. Therefore, removal of the spleen can increase the risk of infections, especially those caused by encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. Vaccinations and preventive measures are often recommended for individuals who have undergone splenectomy to reduce the risk of infections.
Post-Splenectomy Syndrome: Some individuals may experience a condition known as post-splenectomy syndrome, characterized by an increased susceptibility to certain infections, particularly those caused by encapsulated bacteria. This syndrome may also include other complications such as thrombocytosis (elevated platelet count) and venous thromboembolism.
Long-Term Effects: Splenectomy may have long-term implications on the body's immune function and overall health. Individuals who have undergone splenectomy require lifelong medical monitoring and may need to take preventive measures to reduce the risk of infections and other complications.

Complications After Splenectomy

After splenectomy, individuals become more susceptible to infections, particularly in the initial months following the procedure. The most concerning infections are often caused by bacteria such as Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. To mitigate the risk of these infections, vaccination against pneumococcal, meningococcal, and H. influenzae is strongly recommended.

Ideally, these vaccinations should be administered at least two weeks before scheduled splenectomy. However, in cases where emergency splenectomy is required, vaccinations can be given within two weeks after the surgery. This vaccination strategy aims to bolster the individual's immune response and enhance protection against these bacterial infections, which can pose serious health risks in the absence of a functioning spleen.

Pre and Post Splenectomy Vaccination

Laparoscopic Splenectomy

İzmir Dalak cerrahisi splenektomi tedavisi

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