[What are the dangers of splenectomy in Hodgkin's disease?].

Splenectomy is a surgical procedure of medium severity, the mean lethality rate is 1%, the complication rate 10 to 20%. The surgical risk is dependent upon age and general condition of the patient, the severity of the disease, and the experience of the surgeon. The risk of late complications due to surgery is determined mainly by infections as well as ileus, requiring relaparatomy. The risk of infections is higher in children than in adults: one has to be aware of miningitis and sepsis in about 10% of the patients; half of those cases end lethal. An analysis of advantages versus risks of splenectomy must be made for each patient individually. For optimal treatment it is necessary to know the stage of the disease. Concerning M. Hodgkin, explorative laparatomy combined with splenectomy should be performed in stage I to III A. If, however, the surgical risk is rather high primarily and if there are no therapeutical consequences to be expected, splenectomy should not be performed because of the known risks and disadvantages.