{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:23:43Z","timestamp":1783081423509,"version":"3.54.6"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) is a cornerstone treatment for peritoneal metastases but carries substantial morbidity. Splenectomy is frequently performed during CRS, yet it remains uncertain whether it independently increases postoperative risk or merely reflects greater surgical complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 124 CRS procedures performed between 2014 and 2023 at a tertiary center, including 20 splenectomy cases. Operative characteristics, morbidity, and mortality were compared between splenectomy and non-splenectomy groups. Propensity score matching (PSM; 1:2 nearest-neighbor) and inverse probability of treatment weighting (IPTW; average treatment effect on the treated) were applied to adjust for baseline imbalances across age, ASA score, PCI, blood loss, primary tumor type, sex, and number of anastomoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients undergoing splenectomy exhibited higher PCI scores (median 18.5 vs 9;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), greater blood loss (775 vs 450\u00a0mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .037), longer operative times (9 vs 6 hours;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007), and more visceral resections (median 4.5 vs 2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Severe complications occurred in 60% of splenectomy vs 27% of non-splenectomy cases (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007), while mortality did not differ significantly (15% vs 8.7%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .408). After adjustment, splenectomy was not an independent risk factor for morbidity (PSM: OR 2.69,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .193; IPTW: OR 1.76,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .37). Higher ASA score, perioperative fluid replacement, and blood loss remained significant predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Splenectomy during CRS correlates with higher observed morbidity but not with independently increased risk after controlling for surgical complexity. These findings suggest splenectomy reflects procedural burden rather than a direct hazard, underscoring the importance of contextual interpretation and vigilant perioperative management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261465400","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:14:52Z","timestamp":1782796492000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Splenectomy During Cytoreductive Surgery: Marker of Surgical Burden or Independent Predictor of Morbidity?"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1433-3431","authenticated-orcid":false,"given":"Olgun","family":"Erdem","sequence":"first","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tolga","family":"Canbak","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aylin","family":"Acar","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"K\u0131l\u0131\u00e7","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cem","family":"Yal\u00e7\u0131nkaya","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1854-7437","authenticated-orcid":false,"given":"Fatih","family":"Ba\u015fak","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2020-001368"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2020-001312"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.21037\/jgo.2017.07.09"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2022-003928"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5147-x"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2024-005462"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2020.1824043"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2022.08.023"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16040790"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyf085"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.20114"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S172687"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261465400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261465400","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261465400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:56:20Z","timestamp":1783079780000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261465400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":12,"alternative-id":["10.1177\/00031348261465400"],"URL":"https:\/\/doi.org\/10.1177\/00031348261465400","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"article-number":"00031348261465400"}}