Splenectomy at colectomy—not to be dismissed

▸ Wakeman CJ, Dobbs BR, Frizelle FA, . The impact of splenectomy on outcome after resection for colorectal cancer: a multicenter, nested, paired cohort study. Dis Colon Rectum 2008;51:213–17.

Incidental injury to the spleen necessitating its removal is an infrequent but recognised complication of left-sided colonic resection. Although little doubt exists that there are potential septic sequelae of splenectomy, deterioration in cancer outcome has not been a common concern. This study was designed to determine whether incidental splenectomy for iatrogenic injury affects long term cancer-specific survival in patients having resection of an adenocarcinoma of the sigmoid or rectum. The authors conducted a retrospective case–matched review of patients undergoing surgery for colorectal cancer with incidental splenectomy in five major New Zealand teaching hospitals between 1 January 1990 and 31 December 1999. These cases were matched with patients from the same centre, of the same age and gender, with the same stage of disease and operation, who did not require a splenectomy at the time of their surgery.

Fifty-five patients were identified who had an iatrogenic splenectomy. Follow-up from time of surgery to …