medigraphic.com
ISSN 1025-0255 (Electronic)

2012, Number 5

<< Back Next >>

AMC 2012; 16 (5)

Splenectomy in childhood with hematological diseases

Castelló GM, Delgado MN, Hernández ME, Pla DMJ

Language: Spanish
References: 30
Page: 1573-1584
PDF size: 130.76 Kb.


ABSTRACT

Background: splenectomy is one of the most common surgical procedures performed in pediatric surgery. Many hematological diseases in children are treated with partial or total removal of the spleen. Objective: to assess the results of splenectomies performed in children with hematological diseases at the Pediatric Provincial Hospital Dr. Eduardo Agramonte Piña, Camagüey, from January 2000 to December 2009. Methods: a descriptive study was carried out in patients under eighteen years old who underwent splenectomy for hematological diseases. Data were obtained from the individual clinical histories and from the Hematology service. Information processing included the calculation of descriptive statistics and correlation between variables. Results: The majority of patients were more than ten years old at surgery, females prevailed. The main indication for splenectomy in patients with immune thrombocytopenic purpura was the lack of response to medical treatment, followed by sickle cell anemia with splenic sequestration crisis, and hereditary spherocytosis requiring multiple blood transfusions. More than a half of patients were admitted to hospital for six to seven days, and this time was lower when splenectomy was total. There were no complications related to the surgical intervention. In most cases, the clinical and hematological progress was favorable after surgery, although, some cases showed splenic remnant’s regrowth with hemolysis treated with partial splenectom y for hereditary spherocytosis.


REFERENCES

  1. McClusky DA, Skandalakis LJ, L.Colborn G, Skandalakis JE. Tribute to a Triad: History of Splenic Anatomy, Physiology, and Surgery—Part 1. World J Surg. 1999;23:4918.

  2. Rodríguez ALF. Esplenectomías en la infancia [Tesis]. Ciudad de la Habana: Instituto Superior de Ciencias Médicas; 1991.

  3. Kubota M, Adachi S, Usami I, Okada M, Kitoh T, Shiota M, et al. Characterization of chronic idiopathic thrombocytopenic purpura in Japanese children: a retrospective multicenter study. Int J Hematol. 2010;91:2527.

  4. Hollingsworth CL, Rice HE. Hereditary spherocytosis and partial splenectomy in children: review of surgical technique and the role of imaging. Pediatr Radiol. 2010;40:117783.

  5. Quirolo K, Vichinski E. Hemoglobin disorders. En: Behrman RE, Kliegman RM, Henson HB, editores. Nelson Textbook of Pediatrics. 17ma ed. Filadelfia: Saunders; 2004. p. 162434.

  6. Beauchamp RD, Holzman MD, Fabian TC. Spleen. En: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editores. Sabiston Textbook of Surgery. 17ma ed. Filadelfia: Elsevier Saunders; 2004. p. 1679708.

  7. King H, Shumaker H. Splenic studies. Susceptibility to infection after splenectomy performed in infancy. Ann Surg. 1952;136(2):23942.

  8. Garrote HS, Morán VP, Jaime JCF, Cisneros HZ, López LGM, Herrera MG, et al. Evaluación a largo plazo de la esplenectomía parcial en pacientes con esferocitosos hereditaria. Rev Cubana Hematol Inmunol Hemoter. 2010;26 (1):3345.

  9. Schilling RF. Risks and benefits of splenectomy versus no splenectomy for hereditary spherocytosisa personal view. Br J Haematol. 2009;145(6):72832.

  10. Rice HE, Oldham KT, Hillery CA, Skinner MA, O’Hara SM, Ware RE. Clinical and hematologic benefits of partial splenectomy for congenital hemolytic anemias in children. Ann Surg. 2003;237 (2):2818.

  11. López LGM. Evaluación a largo plazo de la esplenectomía parcial en la esferocitosis hereditaria [Tesis de Maestría]. Ciudad de La Habana: Universidad de Ciencias Médicas de La Habana; 2009.

  12. Tracy ET, Rice HE. Partial splenectomy for hereditary spherocitosis. Pediatr Clin N Am. 2008;55:50319.

  13. Svarch E, Vilorio P, Nordet I, Chesney A, Batista J, Torres L, et al. Partial Splenectomy in children with Sickle Cell Disease and repeated episodis of Splenic Secuestration. Hemoglobin. 1996;20:393400.

  14. Rao A, Wilson DB. Hematology and Oncology. En: Dusenbery SM, White AJ, editores. The Washington Manual of Pediatrics. 1ra ed. St. Louis: Lippincot Williams & Wilkins; 2009. p. 25072.

  15. BaderMeunier B, Gauthier F, Archambaud F, Cynober T, Mielot F, Dommergues JP, et al. Longterm evaluation of the beneficial effect of subtotal splenectomy for management of hereditary spherocytosis. Blood. 2001;97 (2):399403.

  16. Tchernia G, Gauthier F, Mielot F, Dommergues JP, Yvart J, Chasis JA, et al. Initial assessment of the beneficial effect of partial splenectomy in hereditary spherocytosis. Blood. 1993;81(8):201420.

  17. Haricharan RN, Roberts JM, Morgan TL, Aprahamian CJ, Hardin WD, Hilliard LM, et al. Splenectomy reduces packed red cell transfusion requirement in children with sickle cell disease. J Pediatr Surg. 2008;43:10526.

  18. Durakbasa CU, Timur C, Sehiralti V, Mutus M, Tosyali N, Yoruk A. Pediatric splenectomy for hematological diseases: outcome analysis. Pediatr Surg Int. 2006;22:6359.

  19. Nouri A, Montalembert Md, Revillon Y, Girot R. Partial splenectomy in sickle cell sy ndr om e s. A r c h D i s C hi l d. 1991;66:10702.

  20. Mattioli G, Avanzini S, Prato AP, Asquasciati C, Rapuzzi G, Costanzo S, et al. Spleen Surgery in Pediatric Age: SevenYear Unicentric Experience. J Lap Advanc Surg Tech. 2009;19(3):43741.

  21. Diesen DL, Zimmerman SA, Thornburg CD, Ware RE, Skinner MA, Oldham KT, et al. Partial splenectomy for children with congenital hemolytic anemia and massive splenomegaly. J Pediatr Surg. 2008;43:46672.

  22. Minkes RK, Lagzdins M, Langer JC. Laparoscopic versus open splenectomy in children. J Pediatr Surg. 2000;35:699701.

  23. Torelli P, Cavalieri D, Casaccia M, Panaro F, Grondona P, Rossi E, et al. Lapar osc opi c spl enec tom y f or hematological disease. Surg Endosc. 2010;16:96571.

  24. Slater BJ, Chan FP, Davis K, Dutta S. Institutional experience with laparoscopic partial splenectomy for hereditary spherocytosis. J Pediatr Surg. 2010;45:16826.

  25. Alwabari A, Parida L, AlSalem AH. Laparoscopic splenectomy and /or cholecystectomy for children with sickle cell disease. Pediatr Surg Int. 2009;25:41721.

  26. Kalpatthi R, Kane ID, Shatat IF, Rackoff B, Disco D, Jackson SM. Clinical events after surgical splenectomy in children with sickle cell anemia. Pediatr Surg Int. 2010;26:495500.

  27. Wales PW, Carver E, Crawford MW, Kim PCW. Acute chest syndrome after abdominal surgery in children with sickle cell disease: Is a laparoscopic approach better? J Pediatr Surg. 2001;38:71821.

  28. Vick LR, Gosche JR, Islam S. Partial spl enec t om y pr ev ent s spl eni c sequestration crises in sickle cell disease. J Pediatr Surg. 2009;44:208891.

  29. Stoehr GA, Stauffer UG, Eber SW. NearTotal Splenectomy. A new technique for the management of hereditary spherocytosis. Ann Surg. 2005;241:407.

  30. Fuente S, Smith T, Rice HE. Functional and anatomic correlation of splenic regeneration following embolization. Pediatr Int. 2009;51(2):3025.




2020     |     www.medigraphic.com