Splenectomy surgery in Iran

Splenectomy surgery in Iran

Splenectomy surgery in Iran

overview

A splenectomy is surgery to remove the entire spleen, a delicate, fist-sized organ that sits under the left rib cage near the stomach. The spleen is an important part of the body's defense (immune) system. It contains special white blood cells that destroy bacteria and help the body fight infections when you are sick. It also helps remove, or filter, old red blood cells from the body's circulation.

If only part of the spleen is removed, the procedure is called a partial splenectomy.

Unlike some other organs, like the liver, the spleen does not grow back (regenerate) after it is removed.

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Am I a good candidate?

You may need to have your spleen removed if you have an injury that damages the organ, causing its covering to break open, or rupture. A ruptured spleen can lead to life-threatening internal bleeding. Common injury-related causes of a ruptured spleen include car accidents and severe blows to the abdomen during contact sports, such as football or hockey.

A splenectomy may also be recommended if you have cancer involving the spleen or certain diseases that affect blood cells. Certain conditions can cause the spleen to swell, making the organ more fragile and susceptible to rupture. In some cases, an illness, such as sickle cell disease, can cause the spleen to shrivel up and stop functioning. This is called an auto-splenectomy.

Why it's done

Splenectomy is used to treat a wide variety of diseases and conditions. Your doctor may recommend splenectomy if you have one of the following:

  • Ruptured spleen.If your spleen ruptures due to a severe abdominal injury or because of an enlarged spleen (splenomegaly), the result may be life-threatening, internal bleeding.
  • Enlarged spleen.Splenectomy may be done to ease the symptoms of an enlarged spleen, which include pain and a feeling of fullness.
  • Blood disorder.Blood disorders that may be treated with splenectomy include idiopathic thrombocytopenic purpura, polycythemia vera and thalassemia. But splenectomy is typically performed only after other treatments have failed to reduce the symptoms of these disorders.
  • Cancers that may be treated with splenectomy include chronic lymphocytic leukemia, Hodgkin's lymphoma, non-Hodgkin's lymphoma and hairy cell leukemia.
  • A severe infection or the development of a large collection of pus surrounded by inflammation (abscess) in your spleen may require spleen removal if it doesn't respond to other treatment.
  • Cyst or tumor.Noncancerous cysts or tumors inside the spleen may require splenectomy if they become large or are difficult to remove completely.

2Types of spleen removal surgeries

A splenectomy may be performed as a traditional open surgery or as a laparoscopic, or minimally invasive, procedure. You will be under sedation for either procedure.

Open splenectomy

A traditional open surgery involves making a cut down the center of your abdomen. The surgeon then moves aside other tissues to remove your spleen. The incision is then closed with stitches. Open surgery is preferred if you have scar tissue from other surgeries or if your spleen has ruptured.

Laparoscopic splenectomy

This type of surgery is minimally invasive and has a quicker and less painful recovery time than open surgery. In a laparoscopic splenectomy, your surgeon makes just a few small cuts in your abdomen. Then, they use a small camera to project a video of your spleen onto a monitor. Your surgeon can then remove your spleen with small tools. They’ll then stitch up the small incisions. Your surgeon may decide an open surgery is necessary after viewing your spleen on the camera.

Why would you need to have your spleen removed?

A splenectomy is recommended as a treatment for some conditions that cause hypersplenism and might be recommended as a treatment for others. Hypersplenism is not a disease itself, but is more of a syndrome, or a collection of symptoms. It means that the spleen has become overactive, enlarged, and is storing and destroying too many blood cells and platelets.

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Blood and urine tests
  • Review of your current medications
  • ECG
  • Other tests to evaluate the cause of the spleen enlargement
  • Studies to determine rate of destruction of red blood cells and/or platelets
  • Give certain vaccines to boost immune system after surgery

Imaging tests to evaluate the abdomen and spleen may include:

  • X-rays
  • CT scan
  • Ultrasound

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.

Side effects

Splenectomy causes an increased risk of sepsis due to encapsulated organisms (such as S. pneumoniae and Haemophilus influenzae). It has been found that the risk of acquiring sepsis is 10 to 20 times higher in a splenectomized patient compared to a non-splenectomized patient, which can result in death, especially in young children. Therefore, patients are administered the pneumococcal conjugate vaccine (Prevnar), Hib vaccine, and the meningococcal vaccine post-operatively (see asplenia). These bacteria often cause a sore throat under normal circumstances but after splenectomy, when infecting bacteria cannot be adequately opsonized, the infection becomes more severe.

An increase in blood leukocytes can occur following a splenectomy. The post-splenectomy platelet count may rise to abnormally high levels (thrombocytosis), leading to an increased risk of potentially fatal clot formation. Mild thrombocytosis may be observed after a splenectomy due to the lack of sequestering and destruction of platelets that would normally be carried out by the spleen. In addition, the splenectomy may result in a slight increase in the production of platelets within the bone marrow. Normally, erythrocytes are stored and removed from the circulating blood by the spleen, including the removal of damaged erythrocytes. However, after a splenectomy the lack of presence of the spleen means this function cannot be carried out so damaged erythrocytes will continue to circulate in the blood and can release substances into the blood. If these damaged erythrocytes have a procoagulant activity then the substances they release can lead to the development of a procoagulant state and this can cause thromboembolic events e.g. pulmonary embolism, portal vein thrombosis and deep vein thrombosis.There also is some conjecture that post-splenectomy patients may be at elevated risk of subsequently developing diabetes. Splenectomy may also lead to chronic neutrophilia. Splenectomy patients typically have Howell-Jolly bodies and less commonly Heinz bodies in their blood smears. Heinz bodies are usually found in cases of G6PD (Glucose-6-Phosphate Dehydrogenase) and chronic liver disease.

10 common questions about Splenectomy surgery in Iran

1How long does a splenectomy surgery take?
Removing the spleen takes 2 to 4 hours. It is usually done through one (1) or more very small incisions (cuts) in the belly. This makes recovery faster and less painful than for surgery with one (1) big incision
2Can you live without a spleen?
Technically, people can live with no kidneys, but require dialysis. Spleen: The spleen filters blood and helps the body fight infections, but it's not essential for survival. The spleen can be removed if, for instance, it's damaged. However, people without a spleen are more prone to infections.
3What organ takes over after spleen removal?
If your spleen needs to be removed, other organs such as the liver can take over many of the spleen's functions. This means you will still be able to cope with most infections
4Is a splenectomy major surgery?
A splenectomy is surgery to remove the entire spleen, a delicate, fist-sized organ that sits under the left rib cage near the stomach. The spleen is an important part of the body's defense (immune) system. ... If only part of the spleen is removed, the procedure is called a partial splenectomy
5Is spleen removal surgery painful?
After a splenectomy, you are likely to have pain for several days. You may also feel like you have the flu. You may have a low fever and feel tired and nauseated. This is common.
6What vaccines are needed after splenectomy?
Current Center for Disease Control (CDC) recommendations for post-splenectomy vaccinations include the polyvalent pneumococcal (Pneumovax 23), the meningococcal (groups A, C, Y, W-135) polysaccharide diphtheria toxoid conjugate (Menactra, for patients ages 11-55) or the meningococcal polysaccharide (Menomune A/C/Y/W- ...
7Does a splenectomy affect life expectancy?
The median actuarial survival after operation was 51 months. Although the series of patients is small, it seems that splenectomy did not have an adverse effect on life expectancy. The haematological status and the quality of life improved after splenectomy in 17 of 19 patients
8Does not having a spleen shorten your life?
In the past, the spleen was considered unnecessary for life. Today, we know that the spleen is a reticuloendothelial organ with important hematologic and immunological functions, including clearance of bacteria from the blood and generation of immune responses to certain pathogens
9What happens after spleen removal?
Removing your spleen is a major surgery and leaves you with a compromised immune system. For these reasons, it's only performed when truly necessary. The benefits of a splenectomy are that it can resolve several health issues such as blood diseases, cancer, and infection that could not be treated any other way
10Can you drink alcohol after a splenectomy?
DON'T drink alcohol. Long-term use can damage your liver and lead to splenomegaly.

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2 Comments

  1. Avatar majid says:

    salaam
    my spleen was removed in an auto accident in sep. 2019.
    can i get a transpla.nt as such?
    please advise.
    thanks
    majid

    • Iranian Surgery Adviser Iranian Surgery Adviser says:

      hello dear majid, please send your medical documents on whatsApp to show our doctors and let you know. this is my whatsApp number +989019290946. thank you

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