Splenectomy: Indications in the General Surgery Department of Ignace Deen Hospital
- 1 General Surgery Department, Ignace Deen National Hospital at Conakry University Hospital, Conakry, Guinea
- 2 General Surgery Department, Ignace Deen National Hospital at Conakry University Hospital, Conakry, Guinea
- 3 General Surgery Department, Ignace Deen National Hospital at Conakry University Hospital, Conakry, Guinea
- 4 General Surgery Department, Ignace Deen National Hospital at Conakry University Hospital, Conakry, Guinea
- 5 General Surgery Department, Ignace Deen National Hospital at Conakry University Hospital, Conakry, Guinea
- 6 Faculty of Health Sciences and Technology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
Abstract
<b>Introduction:</b> Splenectomy is the surgical removal of the spleen. It can be performed during various pathologies, ranging from abdominal trauma to hemoglobinopathies.<b> </b>The progress made in the knowledge of the immune functions of the spleen and the fear of post-splenectomy infectious complications have favored the development of surgical or non-surgical splenic preservation techniques calling into question the dogma of splenectomy. The aim of this study was to determine the indications for splenectomy. <b>Meth</b><b>o</b><b>dology:</b> This was a retrospective, descriptive study lasting 5 years in the general surgery department of the Ignace Deen National Hospital. All files of splenectomized patients were included, our variables were clinical, therapeutic and progressive. <b>Results:</b> We collected 42 cases of splenectomies out of the 2478 surgical procedures performed, representing 1.7% of the department’s surgical activities. The average age was 44 years. The age group of 41 to 50 years was the most represented, <i>i</i>.<i>e</i>. 26% (n = 11) of cases. Sex ratio = 1. Abdominal pain was the reason for consultation in patients, <i>i</i>.<i>e</i>. 100% (n = 42) of cases. The antecedents were dominated by recurrent malaria with 52.3% (n = 22) of cases, then recurrent anemia in 21% (n = 9), and 16.7% (n = 7) had sickle cell disease. Splenomegaly was found in 31 patients, or 73.6%. Ultrasound was performed in all patients. The indications for splenectomy were: isolated splenomegaly with risk of rupture (38%, n = 16), hypersplenism (26%, n = 11) and trauma to the spleen (19.04%, n = 8). Total splenectomy was performed in all cases. The surgical consequences were favorable in 85.7%, (n = 36) with morbidity of 14% (n = 6) and mortality of 9.52% (n = 4). The average length of hospitalization was 10.4 days with extremes of 1 and 22 days. <b>Conclusion:</b> Splenectomy constitutes a relatively common surgical procedure in our context. The indications for splenectomy were isolated splenomegaly with risk of rupture, hypersplenism and trauma to the spleen and total splenectomy was the rule.
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