Late postoperative follow-up of patients undergoing subtotal splenectomy.
OBJECTIVE
Over the past 21 years, we have performed more than 200 subtotal splenectomies, in which the upper splenic pole vascularized only by the gastrosplenic pole vascularized only by the gastrosplenic vessels is preserved, to treat different pathologic conditions. A meticulous follow-up of the postoperative results of this procedure is of fundamental importance.


METHODS
All patients undergoing subtotal splenectomy were invited to be reviewed. A total of 86 patients who had undergone surgery 1 to 20 years ago were gathered; the surgical procedure was performed for one of the following conditions: portal hypertension due to schistosomiasis (n = 43), trauma (n = 31), Gaucher's disease (n = 4), myeloid hepatosplenomegaly due to myelofibrosis (n = 3), splenomegalic retarded growth and sexual development (n = 2), severe pain due to splenic ischemia (n = 2) and pancreatic cystadenoma (n = 1). Patients underwent a hematologic exam, an immunologic assessment, abdominal ultrasonography, computed tomography, scintigraphy and endoscopy.


RESULTS
Increased white blood cell count and platelets were the only hematological abnormalities. No immunologic deficit was found. Esophageal varices were still present in patients who underwent surgery because of portal hypertension although without rebleeding. The ultrasound, tomography and scintigraphy exams confirmed the presence of functional splenic remnants without significant size alteration.


CONCLUSIONS
Subtotal splenectomy seems to be a safe procedure that can be useful in treating conditions involving the spleen. The functions of the splenic remnants are preserved during long periods of time.
Petroianu
Andy
A
Afla Institute of Gastroenterology, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. petroian@medicina.ufmg.br
Resende
Vivian
V
Silva
Rodrigo Gomes da
RG
D005500:Follow-Up Studies; D005776:Gaucher Disease / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000469:parasitology / Q000601:surgery*; D007958:Leukocyte Count; D017060:Patient Satisfaction; D010976:Platelet Count; D011877:Radionuclide Imaging; D012552:Schistosomiasis / Q000601:surgery; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D016896:Treatment Outcome; D014463:Ultrasonography; D014648:Varicose Veins / Q000601:surgery