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Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia. J Pediatr Surg 2016 Jan;51(1):122-7 PMID: 26613837 PMCID: PMC5083068

Pubmed ID

26613837

DOI

10.1016/j.jpedsurg.2015.10.028

Abstract

PURPOSE: The purpose of this study was to define the hematologic response to total splenectomy (TS) or partial splenectomy (PS) in children with hereditary spherocytosis (HS) or sickle cell disease (SCD).

METHODS: The Splenectomy in Congenital Hemolytic Anemia (SICHA) consortium registry collected hematologic outcomes of children with CHA undergoing TS or PS to 1 year after surgery. Using random effects mixed modeling, we evaluated the association of operative type with change in hemoglobin, reticulocyte counts, and bilirubin. We also compared laparoscopic to open splenectomy.

RESULTS: The analysis included 130 children, with 62.3% (n=81) undergoing TS. For children with HS, all hematologic measures improved after TS, including a 4.1g/dl increase in hemoglobin. Hematologic parameters also improved after PS, although the response was less robust (hemoglobin increase 2.4 g/dl, p<0.001). For children with SCD, there was no change in hemoglobin. Laparoscopy was not associated with differences in hematologic outcomes compared to open. TS and laparoscopy were associated with shorter length of stay.

CONCLUSION: Children with HS have an excellent hematologic response after TS or PS, although the hematologic response is more robust following TS. Children with SCD have smaller changes in their hematologic parameters. These data offer guidance to families and clinicians considering TS or PS.

Author List

Englum BR, Rothman J, Leonard S, Reiter A, Thornburg C, Brindle M, Wright N, Heeney MM, Jason Smithers C, Brown RL, Kalfa T, Langer JC, Cada M, Oldham KT, Scott JP, St Peter SD, Sharma M, Davidoff AM, Nottage K, Bernabe K, Wilson DB, Dutta S, Glader B, Crary SE, Dassinger MS, Dunbar L, Islam S, Kumar M, Rescorla F, Bruch S, Campbell A, Austin M, Sidonio R, Blakely ML, Rice HE, Splenectomy in Congenital Hemolytic Anemia Consortium

Authors

Keith T. Oldham MD Professor in the Surgery department at Medical College of Wisconsin
John Paul Scott MD Professor in the Pediatrics department at Medical College of Wisconsin




Scopus

2-s2.0-84952910696   13 Citations

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

Adolescent
Anemia, Sickle Cell
Bilirubin
Child
Female
Hemoglobins
Humans
Laparoscopy
Male
Registries
Reticulocyte Count
Spherocytosis, Hereditary
Splenectomy
jenkins-FCD Prod-332 f92a19b0ec5e8e1eff783fac390ec127e367c2b5