Спленектомія у пацієнтів із гематологічною патологією

Abstract

Splenectomy (SE) in hematologic patients is accompanied by an increased risk due to the presence of a hemostasis violation in most cases. All this determines the search for more favorable methods of surgical intervention in patients with diseases of the blood system.The purpose of the study is to improve the results of surgical treatment of patients with blood system diseases by planning the method of splenectomy.The work was performed on the basis of a comprehensive clinical-laboratory and instrumental examination of 102 patients with various diseases of the blood system that needed surgical treatment. In addition to laboratory diagnosis, special attention was given to the anamnesis: duration of the disease, hormonal therapy; instrumental research methods: ultrasound of the abdominal cavity and CT, as well as nosologies. A harmonic scalpel was used to mobilize the spleen. The EndoGIA-30 stapler (AutoSuture) was used to treat the vascular pedicle.Analysis of the results of SE in patients with hematological profile showed that the choice of surgical access depends on many factors which can be set before operation by dint of ultrasound and CT.There were no conversion cases, which could be explained by the possibility of objective preoperative planning, as a result of which in cases of laparoscopic adverse events, a decision was made to perform open type of SE. The absence of complications and fatal cases at SE in hematologic patients shows the efficacy of the use of harmonic scalpel and EndoGIA-30 (AutoSuture) staplers to mobilize the spleen.The use of ultrasound and CT plays an important role in planning the method of spleenectomy, which avoids cases of conversion. Simultaneous use of harmonic scalpel and Autosuture staplers for performing SE helps to avoid complications.