Lenfoproliferatif hastalıklarda splenektomi endikasyonları ve klinik sonuçlarımız

Öz

Amaç: Hematolojik malignitelerde sistemik tutulum nedeniyle cerrahinin faydası oldukça sınırlıdır. Splenektomi özellikle izole dalak lenfomalarında kimi zaman hem tanı hem de tedavi amaçlı gerekir. Bu çalışmanın amacı lenfoma tanısıyla takip edilen hastalarda splenektominin endikasyon ve yararlarını incelemek, operasyon sonrasındaki klinik sonuçlarımızı tartışmaktır. Gereç ve Yöntemler: Çalışmamıza Ocak 2012 ve Aralık 2019 tarihleri arasında lenfoid malignite nedeniyle hematoloji bölümünce takip edilen ve splenektomi endikasyonuyla tarafımıza yönlendirilen hastalar dahil edildi. Hastalara ait demografik ve klinik veriler ile tedavi sonuçları geriye dönük olarak incelendi. Bulgular: Çalışmaya toplam 44 hasta dahil edildi. Hastaların splenektomi zamanındaki yaş ortalaması 58,2 (±12.4) idi. Hastaların %63,6’sı erkekti. Splenektomi sonrası ortalama takip süresi 12,3 (3-94) aydı. 26 hasta semptomatik splenomegali, 18 hasta medikal tedaviyle düzeltilemeyen trombositopeni ve anemi gibi endikasyonlarla opere edildi. Tedavi sonrası klinik iyileşme splenik marjinal zon lenfomasında diğer lenfoma tiplerine göre daha yüksekti. Sonuç: Son yıllarda özellikle monoklonal antikorlarla yapılan medikal tedaviler sayesinde lenfoma tedavisinde cerrahi ihtiyacı giderek azalmaktadır. Verilerimiz dalak tutulumu olan lenfoid malignitelerde ve özellikle splenik marjinal zon lenfomasında splenektominin etkili ve güvenli bir tedavi seçeneği olduğunu göstermektedir.

Anahtar Kelimeler

• lenfoma
• marjinal zon lenfoma
• splenektomi

Splenectomy indications and clinical results in lymphoproliferative diseases

Öz

Aim: The benefits of surgery are very limited in hematological malignancies due to systemic involvement. Splenectomy is sometimes required for both diagnosis and treatment, especially in isolated splenic lymphomas. The aim of this study is to examine the indications and benefits of splenectomy in patients with lymphoma diagnosis and to discuss our postoperative clinical results. Material and Methods: Patients who were followed up by the hematology department for lymphoid malignancy between January 2012 and December 2019 and referred to us with the indication of splenectomy were included in our study. The demographic and clinical data of the patients and the treatment results were analyzed retrospectively. Results: A total of 44 patients were included in the study. The mean age of the patients at the time of splenectomy was 58.2 (± 12.4). Sixty three percent of the patients were male. The mean follow-up time after splenectomy was 12.3 (3-94) months. Twenty six patients were operated due to symptomatic splenomegaly, 18 patients were operated due to thrombocytopenia and anemia that could not be corrected by medical therapy. Clinical improvement after treatment was higher in splenic marginal zone lymphoma than in other types of lymphoma. Conclusion: In recent years, the need for surgery in the treatment of lymphoma has been decreasing, especially through medical treatments with monoclonal antibodies. Our data show that splenectomy is an effective and safe treatment option in lymphoid malignancies and especially in splenic marginal zone lymphoma.

Anahtar Kelimeler

• lymphoma
• marginal zone lymphoma
• splenectomy

Kaynakça

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