Related Experiment Video
Updated: May 25, 2026
Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions
Published on: December 20, 2024
Evaluation of partial and total splenectomy in children with sickle cell disease using an Internet-based registry
Sofia Mouttalib1, Henry E Rice, Denise Snyder
1Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Insights
Total or partial splenectomy in children with sickle cell disease (SCD) is safe and effective, preventing splenic sequestration without increasing adverse events. This study utilized an internet-based registry to track outcomes.
Area of Science:
- Pediatric Hematology
- Surgical Outcomes
- Sickle Cell Disease Management
Background:
- Clinical outcomes for children with sickle cell disease (SCD) undergoing splenectomy are not well-defined.
- Splenic sequestration is a significant risk in pediatric SCD patients.
- Previous data on total (TS) versus partial splenectomy (PS) outcomes is limited.
Purpose of the Study:
- To establish an internet-based registry for analyzing clinical outcomes in children with SCD who had TS or PS.
- To compare the safety and efficacy of TS versus PS in pediatric SCD patients.
- To hypothesize that both TS and PS are well-tolerated and prevent splenic sequestration.
Main Methods:
- Developed a web-based registry using the Research Electronic Data Capture (REDCap) platform.
- Included children with SCD who underwent TS or PS between 2003 and 2010.
- Compared clinical outcomes between TS and PS cohorts with 1-year follow-up.
Main Results:
- Twenty-four children were analyzed (15 TS, 9 PS).
- No significant differences in surgical time or blood loss; PS had a longer hospital stay (4.1 vs. 2.4 days, P=0.02).
- Low incidence of acute chest syndrome (ACS) post-surgery (20% TS, 15% PS); no recurrent splenic sequestration, thrombosis, or sepsis within 1 year.
Conclusions:
- Both TS and PS demonstrate favorable hematologic outcomes and low adverse event rates in pediatric SCD.
- A REDCap-based registry effectively facilitates data collection and analysis for comparing splenectomy types.
- Splenectomy is a viable option for managing splenic complications in children with SCD.
Background:
Clinical outcomes of children with sickle cell disease (SCD) who undergo total or partial splenectomy (PS) are poorly defined. The purpose of this retrospective study was to initiate an Internet-based registry to facilitate analysis of clinical outcomes for these children. We hypothesized that both surgical procedures would be well tolerated and would eliminate risk of splenic sequestration.
Methods:
We developed a web-based registry using the Research Electronic Data Capture (REDCap) platform. Children were included if they had SCD and underwent total splenectomy (TS) or PS between 2003 and 2010. Clinical outcomes were compared between cohorts, with follow-up to 1 year.
Results:
Twenty-four children were included, TS (n = 15) and PS (n = 9). There were no differences in surgical time or intraoperative blood loss. The length of stay was longer after PS (4.1 ± 1.7 days) compared to TS, (2.4 ± 1.2 days, P = 0.02). Within 30 days of surgery, 2 (20%) patients had acute chest syndrome (ACS) following TS and 2 (15%) patients had ACS after PS. During 1-year follow-up, no patient in either cohort had recurrent splenic sequestration, venous thrombosis or overwhelming postsplenectomy sepsis. All children who were transfused preoperatively to prevent recurrent splenic sequestration successfully discontinued transfusions.
Conclusions:
Both TS and PS result in favorable hematologic outcomes and low risk of adverse events for children with SCD. A REDCap-based registry may facilitate data entry and analysis of clinical outcomes to allow for comparison between different types of splenectomy.