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123. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

02. bis 05.05.2006, Berlin

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Is OPSI the only infectious complication of splenectomy?

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  • A. Budzynski - 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
  • J. Zasada - 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
  • corresponding author M. Matlok - 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
  • K. Rembiasz - 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
  • D. Karcz - 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen

Deutsche Gesellschaft für Chirurgie. 123. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 02.-05.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06dgch5531

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgch2006/06dgch124.shtml

Published: May 2, 2006

© 2006 Budzynski et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Einleitung: Splenectomy is associated with high risk of septic complications. Overwhelming post-splenectomy infection (OPSI) is the mostly studied phenomenon. Far less is known about other infectious complications in this group of patients. The aim of the study: We designed this study to evaluate the risk of short- and long-term septic complications of splenectomy.

Material und Methoden: Between 1994 and 2004 we performed 274 splenectomies for various indications. There were 150 man and 124 women in the study group. Mean age was 43,4 years (ranging form 13 - 90 years). According to indications patients were included into 3 groups; postraumatic rupture (78 patients), haematological disorders (106 patients), others (90 patients)Retrospective data were collected including postoperative complication with particular emphasis on infections and types of offending microorganisms. We performed analysis of risk factors of septic complications in this group. Than follow-up of survivors was performed paying attention to the risk of long-term septic complications.

Ergebnisse: We observed early (within less than 30 days post surgery) infectious complications in 66 patients (24,06%). Sepsis was documented in 15 patients (5,47%), in none of those it was caused by pneumococci. Infectious complications were most common among trauma patients (39,74%) and least in haematologic group (3,77%). Among other risk factors for infections were; multiple rather than isolated trauma (47,17% v. 24%), emergency v. elective operation (40,2% v. 12,1%), classical v. laparoscopic procedure (35% v. 3,19% ) and male v. female sex (31,37% v. 14,88%). Strong relationship between level of contamination of the operating field and septic complications was documented. Only 5% of cultures revealed microbes typically causing OPSI. Bacteria constituting physiological gut flora caused more than 1/3 complications. Higher risk of late (more than 30 days post surgery) complications was documented. There was one fatal case of OPSI. 10,07% of patients were hospitalized because various infectious problems. Further 17,27% reported higher than previously incidence of infections treated at home.

Schlussfolgerung: Splenectomy markedly increases short- and long-term risk of infectious complications other than OPSI.