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December 1962

Indications for Splenectomy: Changing Concepts as a Result of Advances in Hematology

Author Affiliations

Markle Scholar in the Medical Sciences (Dr. Ballinger).; From the Department of Surgery, Jefferson Medical College.

Arch Surg. 1962;85(6):913-927. doi:10.1001/archsurg.1962.01310060049013

Introduction  Recent years have seen several advances in the surgery of the spleen. Steroid therapy has modified the role of splenectomy in acquired hemolytic anemia and idiopathic thrombocytopenic purpura. Red cell survival studies have given a clearer understanding of basic mechanisms in leukemia, thalassemia major (Cooley's anemia) and myelofibrosis and have led to more clearly defined indications for splenectomy. Better understanding of the pathology of congestive splenomegaly has caused a revision of the indications for splenectomy in that condition.Few surgeons have concentrated experience with less common conditions for which splenectomy is advised, and there is still confusion in the use of terms such as hypersplenism, splenic anemia, and Banti's disease.The purpose of this review is to:1. Provide a clearer understanding of the basic mechanisms of certain conditions for which splenectomy is advised. This of necessity involves an explanation of the terms hypersplenism and Banti's disease.2. Present

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