Long‐Term Outcomes After Elective Splenectomy for Haematological Disease: A 27‐Year Single‐Centre Study
- 1Sydney Medical School University of Sydney Sydney New South Wales Australia
- 2Upper Gastrointestinal Surgical Unit Royal North Shore Hospital St Leonards New South Wales Australia
- 3Department of Haematology Royal North Shore Hospital St Leonards New South Wales Australia
Abstract
Background: Splenectomy has traditionally been used to treat a range of haematological diseases. Advances in medical therapies and minimally invasive surgery have altered its therapeutic role. This study evaluates evolving indications and outcomes of elective splenectomy in an Australian teaching hospital over a 27‐year period.
Methods: Adult patients undergoing elective splenectomy for haematological disease between 1999 and 2025 at a single tertiary institution were identified from medical records. Caseload, demographics, operative approach, complications and follow‐up outcomes were assessed either annually or over three 9‐year cohorts. Regression and Fisher's exact tests were used for trend analysis.
Results: Seventy patients underwent splenectomy. The annualised caseload and cohort patient age decreased significantly over the study period (p = 0.005 and 0.020, respectively). Benign indications accounted for 54% of patients, most commonly immune thrombocytopenia, while lymphoma and myelofibrosis predominated among malignant indications. There was an upward trend for laparoscopic splenectomy over time (p = 0.051), reduced conversion rates (p = 0.189) and a decrease in operative time (p = 0.012). The overall post‐operative complication rate was 21.4%, and most were minor. Ninety‐day post‐operative mortality was zero. The median follow‐up was 9.1 years. Long‐term survival was primarily influenced by underlying haematologic disease, with most long‐term survivors well with normal platelet counts.
Conclusion: Despite declining referrals in the era of targeted therapies, splenectomy remains a safe and effective treatment option in selected patients. Outcomes are favourable when performed laparoscopically in experienced hands, and long‐term follow‐up demonstrates sustained haematologic benefit in surviving patients.
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BibTeX
@article{barrett2026longterm,
title = {{Long‐Term Outcomes After Elective Splenectomy for Haematological Disease: A 27‐Year Single‐Centre Study}},
author = {Salil Dutt Barrett and Anthony Downhill and Douglas Greer and William Stevenson and Ian Kerridge and Chris Ward and Matthew Greenwood and Naomi Mackinlay and Luke Coyle and Thomas J. Hugh},
journal = {Anz Journal of Surgery},
year = {2026},
month = sep,
doi = {10.1111/ans.70961},
url = {https://doi.org/10.1111/ans.70961},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Long‐Term Outcomes After Elective Splenectomy for Haematological Disease: A 27‐Year Single‐Centre Study
AU - Salil Dutt Barrett
AU - Anthony Downhill
AU - Douglas Greer
AU - William Stevenson
AU - Ian Kerridge
AU - Chris Ward
AU - Matthew Greenwood
AU - Naomi Mackinlay
AU - Luke Coyle
AU - Thomas J. Hugh
PY - 2026
DA - 2026/09/09
JO - Anz Journal of Surgery
DO - 10.1111/ans.70961
UR - https://doi.org/10.1111/ans.70961
AB - Background: Splenectomy has traditionally been used to treat a range of haematological diseases. Advances in medical therapies and minimally invasive surgery have altered its therapeutic role. This study evaluates evolving indications and outcomes of elective splenectomy in an Australian teaching hospital over a 27‐year period. Methods: Adult patients undergoing elective splenectomy for haematological disease between 1999 and 2025 at a single tertiary institution were identified from medical records. Caseload, demographics, operative approach, complications and follow‐up outcomes were assessed either annually or over three 9‐year cohorts. Regression and Fisher's exact tests were used for trend analysis. Results: Seventy patients underwent splenectomy. The annualised caseload and cohort patient age decreased significantly over the study period (p = 0.005 and 0.020, respectively). Benign indications accounted for 54% of patients, most commonly immune thrombocytopenia, while lymphoma and myelofibrosis predominated among malignant indications. There was an upward trend for laparoscopic splenectomy over time (p = 0.051), reduced conversion rates (p = 0.189) and a decrease in operative time (p = 0.012). The overall post‐operative complication rate was 21.4%, and most were minor. Ninety‐day post‐operative mortality was zero. The median follow‐up was 9.1 years. Long‐term survival was primarily influenced by underlying haematologic disease, with most long‐term survivors well with normal platelet counts. Conclusion: Despite declining referrals in the era of targeted therapies, splenectomy remains a safe and effective treatment option in selected patients. Outcomes are favourable when performed laparoscopically in experienced hands, and long‐term follow‐up demonstrates sustained haematologic benefit in surviving patients.
SN - 1445-1433
SN - 1445-2197
ER -