The Changing Landscape of Splenectomy in Women at a UK University Teaching Hospital: The Role of Gynaecological Oncology

ObjectiveTo characterise the volume, indications and surgical context of splenectomy in adult women at a UK tertiary centre, comparing gynaecological oncology (GO) with general surgery and surgical subspecialities (GS), and to examine the distribution of procedural exposure between specialities. MethodsRetrospective study of all female patients who underwent splenectomy at the University Hospitals of Derby and Burton (UHDB) NHS Foundation Trust, Derby, UK, from January 2014 to June 2025.Exclusion criteria were male sex, splenic biopsy only, splenunculus removal only and age <18 years.Data were extracted from electronic patient records and collated in Microsoft Excel.Categorical and continuous variables were summarised descriptively, with Fisher's exact test, the Mann-Whitney U test and negative binomial regression analyses used as appropriate; statistical significance was set at p < 0.05. ResultsNinety-four women underwent splenectomy; 69 (73.4%) underwent elective procedures, and 25 (26.6%)underwent emergency procedures.GO performed 46/94 (49.0%) procedures and 46/69 (66.7%) elective procedures; all GO procedures were elective.GS performed 23/69 (33.3%) elective procedures, 48/94 (51.0%) of all splenectomies and all emergency splenectomies.GO splenectomies were undertaken for advanced Müllerian malignancy and formed part of cytoreduction, with concomitant omentectomy (97.8%), uterine/adnexal resection (84.8%) and colorectal resection (60.9%).In contrast, 79.2% of GS splenectomies were isolated procedures, and indications were heterogeneous.Malignant involvement was confirmed histologically in 89.1% of GO splenectomies.Among GS procedures for known or suspected malignancy, 7/15 (46.7%) had malignant involvement; among five procedures for suspected solid-organ malignancy, two (40%) were confirmed.The mean number of splenectomies per surgeon per year was 1.00 for GO compared with 0.23 for GS.Temporal trends were non-significant. ConclusionGO has become a major contributor to elective splenectomy in women.Its concentrated multivisceral practice contrasts with dispersed GS exposure.These findings highlight potential opportunities for crossspeciality discussion of operative experience and training.