Splenectomy
A splenectomy is the surgical removal of the spleen, an organ that helps to regulate the composition of the blood and plays an important role in fighting infections. The spleen is on the left side of the abdomen near the rib cage. When part of the spleen is removed the procedure is called a partial splenectomy. In some cases, in patients with certain diseases, the spleen may shrivel up and stop functioning without intervention. This is called an auto-splenectomy.
Reasons for a Splenectomy
There are many reasons that the spleen must be removed and only some include damage to the spleen itself. A splenectomy may be required when one of the following occurs
Ruptured Spleen
Common causes of spleen rupture are motor vehicle accidents and contact sports injuries. In these cases, the splenectomy is an emergency surgical procedure because the internal bleeding caused by a ruptured spleen may be life-threatening.
Enlarged Spleen
This condition, known as splenomegaly, may result from some blood disorders, noncancerous cysts or tumors. When the spleen enlarges it is more prone to rupture and a splenectomy may have to be performed.
Hereditary, Blood, or Autoimmune Disorders
Some diseases, such as sickle cell disease, thalassemia and lupus, may result in the need for a splenectomy. Usually, the surgery is required if the patient's underlying disease results in spleen enlargement that cannot be improved with medication or other treatment.
Cancer
Blood cancers, such as leukemia and lymphoma, as well as malignancies detected in the spleen itself, may necessitate a splenectomy. The operation is performed when only surgical intervention will stop the spread or relieve the symptoms of disease.
Blood Vessel Problems
A splenectomy may be performed if there is a blood clot in one of the spleen's blood vessels. This surgery may also be required if there is an aneurysm in the spleen's artery, a rare occurrence.
Splenic Tumor or Abscess
One or more large cysts or tumors on the spleen, even if they are benign, may necessitate a splenectomy since it may be impossible to remove them without this surgery. If an abscess develops on the spleen, a splenectomy may be performed to remove the source of infection.
Cirrhosis
Complications of the conditions of this disease on the liver may necessitate removal of the spleen. The surgery may also be helpful to patients who have developed hypersplenism as a result of their liver disease.
Types of Splenectomy
Splenectomies may be performed as open surgery or laparoscopically, if the spleen has not become too enlarged. In some cases, it may be possible to shrink the spleen prior to surgery by restricting blood flow to the area. Wherever appropriate, laparoscopic surgery is preferable since it is less invasive, and involves smaller incisions, less scarring, less pain, and a shorter recovery period. In either type of surgery, general anesthesia is used.
Risks of a Splenectomy
There are risks associated with any surgical procedure, though fortunately they occur rarely. For splenectomy patients, possible complications include:
- Excessive bleeding
- Blood clots
- Adverse reactions to anesthesia or medications
- Post-surgical infection
- Damage to adjacent organs
- Breathing problems
- Collapsed lung
- Hernia at the incision site
The spleen, unlike certain organs like the liver, does not regenerate, and the patient will be more prone to infections without it.
Recovery from a Splenectomy
Recovery from a splenectomy varies depending on the patient's overall physical condition. If the procedure is done laparoscopically, the hospital stay is usually only one or two days. If open surgery is performed, the patient will probably be in the hospital for close to a week. In about 4 to 6 weeks, full healing should take place.
The increased tendency to infections after a splenectomy requires certain precautions. For some patients, a long-term regimen of antibiotics is recommended. In all cases, patients are instructed to be especially carefully about:
- Avoiding exposure to contagious diseases
- Consulting with their doctors if they contract an illness
- Have a medical consult before undertaking exotic travel
- Having all recommended vaccinations and immunizations
Statistics show that health risks after recovery from a splenectomy are greater during the first two post-surgical years and that children who have had the procedure are at greater risks than adults.