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4 months ago
Can you live without a spleen? 6 questions about splenectomy answered by a surgeon

Oftentimes, we hear of patients having their gallbladder, uterus or one of their kidneys removed for health reasons. Presence of malignancies or other medical abnormalities in these organs warrants a surgical removal to improve the patient’s quality of life. But what if your doctor suggests removing a completely healthy organ as a treatment method? That’s bound to leave most patients confused. Splenectomy or surgical removal of the spleen is one such method where sometimes the healthy organ is removed to improve certain underlying health conditions. However, the spleen may also be removed in case of infections, malignancies and cysts in the organ. It may be performed laparoscopically or otherwise and can be total or partial.

Here are some of the important questions about splenectomy answered by Dr Aashish Shah, MAS, GI and Gen Surgery, Bariatric Surgery, Fortis Hospitals, Bangalore.

How important is the spleen to the body?

Dr Shah says that spleen, the largest organ in the human lymphatic system, is entrusted with filtering blood, acting as a store for components of blood and helping the body fight infections. It has an important portfolio to handle in the human body, but it is not uncommon to have it removed.

Why is spleen removal recommended?

“In many cases, the spleen may have to be removed on an emergency basis or on elective grounds,” says Dr Aashish Shah. Spleen removal is prescribed to treat blood disorders like sickle cell anaemia, hemolytic anaemia, ITP or idiopathic thrombocytopenic purpura, etc. where the body faces a shortage of cells.  Since one of the spleen’s jobs is to remove old blood cells, removing the organ ensures that are more blood cells in circulation. “Injuries to the spleen that results in severe bleeding necessitates emergency removal of the spleen. In cases of blood disorders like ITP, where the spleen is killing one’s own platelets, or if the spleen harbours pus, abscess or huge cysts and is troubling the patient, the organ is surgically removed,” he adds.

How does the human body cope without a spleen?

Every organ has a role to play in the body. Without the spleen to filter blood cells and to support immune functions,  how would we fare? The truth is the human body is more resilient than what we’d like to give it credit for. Other organs in the body step up and bridge the gap created by the loss of spleen. “The bone marrow and the liver take over the functions of the spleen and help in providing immunity to the body,” says Dr Shah. What’s more incredible, according to Dr Shah, is that sometimes — in 25 to 30 percent of the cases — new spleens can form in the body, either by spillage or redundant spleen tissues that are left behind. These tissues then enlarge in a condition known as splenosis and function like a spleen.

When is splenectomy not recommended?

Although splenectomy can save lives, some patients may not be the right candidate for the treatment. “The spleen is not removed if it is the only organ helping in synthesising blood or is compensating abdominal intestinal blood pressures. It is also not recommended if the patient is suffering from bleeding disorders,” says Dr Shah.

What postoperative care is recommended to the patient?

After the emergency surgery, the patient has to be immunised with a pneumococcus vaccine to prevent infections. In the case of an elective surgery, where the splenectomy is planned, the patient should be vaccinated before the procedure, according to Dr Shah. “So patients will be educated about respiratory infections after splenectomy. They should avoid crowded places till the effects of the vaccination kick in,” he says.

Since the spleen is very close to the lungs, there is always a threat of lung collapse once the organ is removed. “That’s why patients are advised to perform breathing exercises to prevent it,” Dr Shah adds.

Another risk of splenectomy is blood clots. With the spleen out of the picture, there will be more platelets in circulation, which can clump together and form clots. Aspirin is prescribed to the patient to prevent the formation of such life-threatening clots.

However, Dr Shah assures that life after splenectomy won’t be very tough. ” Patients are really not disabled, as they lead a normal life like any other. Especially if the patient has undergone laparoscopic surgery chances of patient developing chest problems are significantly low. They can be back to exercising, running, gymming etc.,” he concludes.

Image source: Shutterstock

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