Splenectomy is sometimes necessary.In other disorders, the spleen may or may not be removed.It is subject to removal in the following cases:
• Hodgkin's disease, a serious form of cancer that causes swollen lymph nodes and impairs the functioning of the immune system.Treatments such as radiation, chemotherapy, and surgical removal of the spleen can exacerbate this malfunction, increasing the likelihood of infection.A splenectomy is sometimes done to find out how far the disease has advanced.Splenectomy has been shown to increase the risk of secondary acute leukemia in patients with Hodgkin's disease.
• Cellular leukemia.Patients may experience discomfort due to a very enlarged spleen caused by leukemia growing in the spleen.Splenectomy was the only treatment for this disease;but due to complications associated with splenectomy (white blood cell count, fatigue, frequent infections, and easy bleeding or bruising), doctors are now more likely to recommend chemotherapy.
• Chronic myeloid disorders.These disorders include chronic myelocytic leukemia, polycythemia, major thrombocythemia, and agogenic myeloid metaplasia (myelofibrosis);they enlarge the spleen to varying degrees.In the early stages of chronic myelocytic leukemia, splenectomy is of little benefit.
• Myelofibrosis.Myelofibrosis is a disorder in which the bone marrow is replaced with fibrous tissue.It causes severe and painful splenomegaly.Splenectomy does not cure myelofibrosis, but it can be done to relieve pain caused by a swollen spleen.
• Thrombotic thrombocytopenic purpura (TTP).TTP is a rare disease marked by fever, kidney failure, and abnormal platelet counts.Splenectomy is one part of the treatment for TTP.
• Autoimmune hemolytic disorders.These disorders can affect patients of any age, but are most common in patients over 50.Erythrocytes are destroyed by antibodies produced by the patient's own body (autoantibodies).
• Thalassemia.Thalassemia is an inherited form of anemia that is most common among people of Mediterranean descent.A splenectomy is sometimes done if the patient's spleen becomes painfully enlarged.
Patients should be carefully assessed regarding the need for splenectomy.Because of the spleen's role in protecting against infection, it cannot be removed if necessary.The operation is relatively safe for young and middle-aged adults.The elderly, especially those with heart or pulmonary disease, are more susceptible to post-surgical infections.Thromboembolism after splenectomy is another complication for this group of patients, which has an approximately 10% mortality rate after surgery. find more info