title: Splenectomy complicating left nephrectomy.
abstract: OBJECTIVE
  We attempted to clarify the details of incidental splenectomy complicating left nephrectomy.
  
  
  METHODS
  We reviewed the literature and operations involving splenectomy performed during left nephrectomy between 1984 and 1994 at our university. Factors reviewed included patient characteristics, renal pathology, mechanisms of injury, blood transfusions and postoperative complications.
  
  
  RESULTS
  Of the 418 left nephrectomies 18 (4.3%) resulted in splenectomy via a transperitoneal approach. Patients with a large or upper pole renal lesion, malignancy or advanced age are increasingly likely to undergo unanticipated splenectomy.
  
  
  CONCLUSIONS
  Our results, combined with recommendations from the Centers for Disease Control and Prevention, suggest that all patients older than 65 years undergoing left transperitoneal nephrectomy or those at increased risk for splenic injury should receive preoperative pneumococcal vaccination.
mesh_terms: D000367:Age Factors; D000368:Aged; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000601:surgery; D007674:Kidney Diseases / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery; D008875:Middle Aged; D009392:Nephrectomy; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control; D012307:Risk Factors; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy / Q000706:statistics & numerical data; D014611:Vaccination