Is splenectomy for massive splenomegaly safe in children?

Area of Science:

• Pediatric Surgery
• Hematology
• Surgical Oncology

Background:

• Massive splenomegaly in children presents significant challenges.
• Splenectomy is a potential therapeutic option for severe cases.

Purpose of the Study:

• To analyze the causes, etiology, morbidity, mortality, and therapeutic value of splenectomy for massive splenomegaly in children.
• To evaluate the outcomes of splenectomy in pediatric patients with enlarged spleens.

Main Methods:

• Retrospective review of 115 pediatric patients (<18 years) who underwent splenectomy.
• Detailed analysis of 20 children with massive splenomegaly (spleen weight ≥1,000 g).
• Evaluation of hematological diagnoses, indications for surgery, complications, and outcomes.

Main Results:

• Twenty children underwent splenectomy for massive splenomegaly (16 males, 4 females; age 4-15 years).
• Common diagnoses included sickle cell disease (12), sickle-beta-thalassemia (5), and other thalassemia variants (2), plus chronic myeloid leukemia (1).
• Indications included hypersplenism (11), splenic sequestration crisis (8), and splenic abscess (1); no mortality was observed, with 10% immediate postoperative morbidity.

Conclusions:

• Splenectomy is a safe and effective procedure for children with massive splenomegaly when managed with good perioperative care.
• The surgery led to decreased transfusion requirements and improved blood parameters in relevant patient groups.
• Outcomes suggest significant therapeutic benefits for pediatric patients with massive splenomegaly undergoing splenectomy.