Topic
Splenectomy
About: Splenectomy is a research topic. Over the lifetime, 9278 publications have been published within this topic receiving 156216 citations.
Papers published on a yearly basis
1 / 3
Papers
TL;DR: Patients who die in the ICU following sepsis compared with patients who die of nonsepsis etiologies have biochemical, flow cytometric, and immunohistochemical findings consistent with immunosuppression, and targeted immune-enhancing therapy may be a valid approach in selected patients with sepsi.
Abstract: Context Severe sepsis is typically characterized by initial cytokine-mediated hyperinflammation. Whether this hyperinflammatory phase is followed by immunosuppression is controversial. Animal studies suggest that multiple immune defects occur in sepsis, but data from humans remain conflicting. Objectives To determine the association of sepsis with changes in host innate and adaptive immunity and to examine potential mechanisms for putative immunosuppression. Design, Setting, and Participants Rapid postmortem spleen and lung tissue harvest was performed at the bedsides of 40 patients who died in intensive care units (ICUs) of academic medical centers with active severe sepsis to characterize their immune status at the time of death (2009-2011). Control spleens (n = 29) were obtained from patients who were declared brain-dead or had emergent splenectomy due to trauma; control lungs (n = 20) were obtained from transplant donors or from lung cancer resections. Main Outcome Measures Cytokine secretion assays and immunophenotyping of cell surface receptor-ligand expression profiles were performed to identify potential mechanisms of immune dysfunction. Immunohistochemical staining was performed to evaluate the loss of immune effector cells. Results The mean ages of patients with sepsis and controls were 71.7 (SD, 15.9) and 52.7 (SD, 15.0) years, respectively. The median number of ICU days for patients with sepsis was 8 (range, 1-195 days), while control patients were in ICUs for 4 or fewer days. The median duration of sepsis was 4 days (range, 1-40 days). Compared with controls, anti-CD3/anti-CD28–stimulated splenocytes from sepsis patients had significant reductions in cytokine secretion at 5 hours: tumor necrosis factor, 5361 (95% CI, 3327-7485) pg/mL vs 418 (95% CI, 98-738) pg/mL; interferon γ, 1374 (95% CI, 550-2197) pg/mL vs 37.5 (95% CI, −5 to 80) pg/mL; interleukin 6, 3691 (95% CI, 2313-5070) vs 365 (95% CI, 87-642) pg/mL; and interleukin 10, 633 (95% CI, −269 to 1534) vs 58 (95% CI, −39 to 156) pg/mL; (P Conclusions Patients who die in the ICU following sepsis compared with patients who die of nonsepsis etiologies have biochemical, flow cytometric, and immunohistochemical findings consistent with immunosuppression. Targeted immune-enhancing therapy may be a valid approach in selected patients with sepsis.
1,587 citations
TL;DR: The CD14+/CD16+ cells appear to represent a new monocyte subset with a distinct functional repertoire and a survey of various tissues revealed that a large proportion of the alveolar macrophage, but not of the peritoneal macrophages, express the CD14-/ CD16+ phenotype.
1,044 citations
TL;DR: Although the risk of surgery is an important consideration, splenectomy provides a high frequency of durable responses for adult patients with ITP and the ability to predict who will respond, and the frequency of surgical complications all remain uncertain.
679 citations
TL;DR: This Review critically assess clinical and diagnostic aspects of splenic dysfunction and highlight new perspectives in the prevention of overwhelming post-splenectomy infections.
599 citations
TL;DR: It is concluded that in most instances the distal pancreas can be mobilized for resection or inspection without the need for splenectomy.
Abstract: • This report describes a rapid, easy, and safe means of saving the spleen while resecting or fully mobilizing the pancreatic tail. The pancreas is separated from the spleen by dividing the splenic artery and vein distal to the tip of the pancreas. The spleen survives on the short gastric vessels, which are carefully preserved. The technique has been applied successfully in 22 of 25 consecutive patients with chronic pancreatitis (n=13), acute pancreatitis and pancreatic necrosis (n=3), cystic neoplasm of the pancreas (n=4), islet cell tumor (n=2), and ductal adenocarcinoma (n=3). The spleen could not be saved in three patients because of splenic hilar involvement by tumor or scar. Normal postoperative blood cell counts and spleen scans proved splenic viability and function. There was only one complication, a late splenic abscess that developed in a spleen of twice-normal size. It is concluded that in most instances the distal pancreas can be mobilized for resection or inspection without the need for splenectomy. Splenomegaly may be a contraindication because the short-vessel gastric blood supply may be inadequate to nourish the increased tissue mass. The technique is applicable to the treatment of pancreatic tumors, trauma, and pancreatitis. ( Arch Surg 1988;123:550-553)
590 citations
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Performance Metrics
| Year | Papers |
|---|---|
| 2026 | 1 |
| 2025 | 149 |
| 2024 | 266 |
| 2023 | 431 |
| 2022 | 642 |
| 2021 | 250 |