Emergency surgical treatment for patients with acute leukemia.

A series of 21 emergency operations performed upon 19 patients with acute leukemia was reviewed. The most common procedure performed was laparotomy for intra-abdominal emergency complications which was associated with a high mortality (58 per cent), especially in those patients with leukemia not in remission (78 per cent). Patients who underwent extra-abdominal procedures, even with leukemia not in remission, had a low mortality (14 per cent). All five patients who were operated upon while in remission survived. The most accurate prognostic signs associated with postoperative mortality were abnormal white blood cell counts and development of leukemia not in remission. Early surgical intervention is advised combined with intensive supportive care to improve survival rates of patients with acute leukemia who undergo emergency surgical procedures.