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[Partial splenectomy in sickle cell disease].

A I Gutiérrez Díaz1, E Svarch1, A Arencibia Núñez1

  • 1Instituto de Hematología e Inmunología, La Habana, Cuba.

Anales De Pediatria (Barcelona, Spain : 2003)
|March 4, 2014
PubMed
Summary

Partial splenectomy in sickle cell disease is safe, with no increased clinical events compared to non-splenectomized patients, though hepatic sequestration crises were more frequent.

Keywords:
DrepanocitosisEsplenectomía parcialEsplenectomía totalPartial splenectomySickle cell diseaseTotal splenectomy

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Area of Science:

  • Hematology
  • Pediatric Surgery

Background:

  • Total splenectomy in sickle cell disease (SCD) carries high risks of sepsis.
  • Partial splenectomy outcomes in SCD are less understood.
  • This study compares clinical and lab results of partial splenectomy versus no splenectomy in SCD patients.

Purpose of the Study:

  • To evaluate the safety and clinical outcomes of partial splenectomy in pediatric sickle cell disease patients.
  • To compare patients who underwent partial splenectomy with a control group of non-splenectomized patients.

Main Methods:

  • A retrospective study of 54 SCD patients who underwent partial splenectomy in childhood.
  • Comparison with 54 randomly selected non-splenectomized SCD patients.
  • Analysis of clinical and laboratory data, including postoperative complications and incidence of clinical events.

Main Results:

  • Partial splenectomy, often for splenic sequestration crisis, was performed at a mean age of 4.1 years.
  • Common complications included fever of unknown origin and acute chest syndrome.
  • Leukocytes, neutrophils, and platelets increased post-splenectomy, with neutrophils and platelets remaining elevated compared to controls.
  • Hepatic sequestration crisis was more frequent in the partial splenectomy group.

Conclusions:

  • Partial splenectomy is a safe procedure for pediatric sickle cell disease patients.
  • No significant differences in clinical events were observed between partial splenectomy and non-splenectomized groups, except for a higher incidence of hepatic sequestration crisis.