Role Of Splenectomy In Management Of Blood Diseases:

El Sayed Afify Abd El Mabood

The spleen is considered an important organ for children because of its immunological and haematological functions. Many studies were done to assess its important role, recommending conservation of the spleen as much as possible. Also, the threat of overwhelming sepsis after splenectomy in the very young child has been adequately documented. The threat of such infection, as well as, complications of the procedure and surgical mortality, have led many physicians and surgeons to advise against splenectomy inspite of the recognized benefits of such a procedure in controlling the child’s primary disease.Blood is a living fluid tissue circulating within the vascular system to link every body cell with the external environment and this composed of fluid (plasma) part & cellular (cells) element.For many years splenectomy was the main point of contact between hematology and surgery and the indication for splenectomy an hematology are numerous; either diagnostic and staging porposes or curatives as in ITP… etc.The role of splenectomy in the management of hematologic disorders has greatly increased in recent years. In general, removal of the spleen in these disorders affects its role in cellular sequestration and destruction and also its role as an immunologtic organ.Surgical techniques have been developed in an attempt to remove the spleen are open splenectomy, larparscopic splenectomy or alternatives. Recently laparoscopic splenectomy has gained popularity and acceptance as an effective allternative to open surgery.The principal disadvantage of splenectomy is the loss of the patient’s ability to respond immunologically to intravenous antigen. the spleen unique vasculature allows prolonged contact between blood and phagocytes to permit the processing of intravenous antigen especially the encapsulated bacteria. This function is very important in young children.There is general recognitions that splenectomy exposes some patients to septic complications, which may be life threatening. Overwhelming sepsis may be rapid in onset with high mortality.