Faculty Collaboration Database

Partial splenectomy for children with congenital hemolytic anemia and massive splenomegaly. J Pediatr Surg 2008 Mar;43(3):466-72

Date

03/25/2008

Pubmed ID

18358283

DOI

10.1016/j.jpedsurg.2007.10.025

Scopus ID

2-s2.0-40749151515 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

Partial splenectomy is an alternative to total splenectomy for the treatment of congenital hemolytic anemias (CHAs) in children, although the feasibility of this technique in the setting of massive splenomegaly is unknown. This study was designed to evaluate the safety and efficacy of partial splenectomy in children with CHAs and massive splenomegaly. This retrospective study examined 29 children with CHAs who underwent partial splenectomy. Children were divided into 2 groups based on splenic size: 8 children had splenic volumes greater than 500 mL, whereas 21 children had splenic volumes less than 500 mL. Outcome variables included perioperative complications, transfusion requirements, hematocrits, reticulocyte counts, bilirubin levels, splenic sequestration, and splenic regrowth. All 29 children underwent successful partial splenectomy with 0.02 to 10 years of follow-up. After partial splenectomy, children overall had decreased transfusion requirements, increased hematocrits, decreased bilirubin levels, decreased reticulocyte counts, and elimination of splenic sequestration. Children with massive splenomegaly had similar outcomes compared with children without massive splenomegaly. Long-term complications included 3 mild infections, 4 cases of gallstones requiring cholecystectomy, and 1 child who required completion splenectomy. Partial splenectomy is a safe, effective, and technically feasible option for children with various CHAs, even in the setting of massive splenomegaly.

Author List

Diesen DL, Zimmerman SA, Thornburg CD, Ware RE, Skinner M, Oldham KT, Rice HE

MESH terms used to index this publication - Major topics in bold

Anemia, Hemolytic, Congenital
Blood Chemical Analysis
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Male
Retrospective Studies
Risk Assessment
Severity of Illness Index
Splenectomy
Splenomegaly
Treatment Outcome