{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:22:34Z","timestamp":1779236554756,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T00:00:00Z","timestamp":1589155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T00:00:00Z","timestamp":1589155200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T00:00:00Z","timestamp":1589155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>With increasing frequency, patients with idiopathic splenomegaly are referred to surgeons for splenectomy. We evaluated the diagnostic utility of splenectomy and feasibility of a minimally invasive approach in the face of idiopathic splenomegaly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed 68 patients who underwent splenectomy for idiopathic splenomegaly. The primary endpoint was the rate of definitive diagnosis based on final surgical pathology of the removed spleen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preoperative workup included a bone marrow biopsy and peripheral blood smear in 93% and 100% of patients, respectively, with none having lymphadenopathy warranting biopsy. Splenectomy provided a definitive diagnosis for 44 (64.7%) patients. Of these, 34 (50%) patients had an underlying malignancy, of which more than half were splenic marginal zone lymphoma. There were 33 (48.5%) laparoscopic, 23 (33.8%) open, 10 (14.7%) laparoscopic converted to open, and two (2.9%) laparoscopic hand\u2010assist cases. Conversion to open was due to splenic size [median craniocaudal length 21.8\u00a0cm (cm)] in eight and staple line bleeding at the splenic hilum in two patients. Overall, the laparoscopic approach was completed in patients with a smaller splenic size compared to open (median craniocaudal length 15.2 vs. 26.0\u00a0cm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The open group had one (1.5%) intra\u2010operative mortality due to uncontrollable hemorrhage. Thirty\u2010day complication rates were similar for laparoscopic and open approaches (<jats:italic>p<\/jats:italic>\u2009=\u20090.10).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Splenectomy is an effective diagnostic modality in determining a pathologic cause for splenomegaly in this patient population. Laparoscopic splenectomy can be performed safely in appropriate cases with craniocaudal splenic size having the largest influence on surgical approach.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05566-3","type":"journal-article","created":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T15:04:05Z","timestamp":1589209445000},"page":"2959-2964","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Diagnostic Utility of Splenectomy in Idiopathic Splenomegaly"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5146-8725","authenticated-orcid":false,"given":"Robert","family":"Naples","sequence":"first","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Bertke","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldo","family":"Fafaj","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel J.","family":"Zolin","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonah D.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clayton","family":"Petro","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Krpata","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajita S.","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Rosenblatt","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic 9500 Euclid Avenue, Desk A100 44195 Cleveland OH 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May 2020","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Ajita S Prabhu: Bard consultant; Medtronic advisory board; Intuitive research support and speak-ing honoraria. Michael J. Rosen: Receives salary support for his role as the medical director of the Americas Hernia Society Quality Collaborative; board member of Ariste Medical Inc. and has stocks from Ariste Medical; ongoing research grants from Pacira Pharmaceuticals and Intuitive Inc. None of these conflicts of interest for Dr. Rosen or Dr. Prabhu are related to the submitted work. All other authors report no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}