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Updated: Apr 14, 2026
Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions
Published on: December 20, 2024
[Infectious complications after surgical splenectomy in children with sickle cell anemia disease]
Cypriano Petrus Monaco Junior1, Patricia Belintani Blum Fonseca1, Josefina Aparecida Pellegrini Braga1
1Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.
Insights
Surgical splenectomy for splenic sequestration in children with sickle cell disease (SCD) did not increase infectious complications over a 6-year follow-up period. This finding supports the safety of splenectomy in managing this SCD complication.
Area of Science:
- Pediatric Hematology
- Infectious Disease
- Surgical Outcomes
Background:
- Sickle cell disease (SCD) increases the risk of severe infections, particularly after splenectomy.
- Splenic sequestration crisis is a serious SCD complication requiring intervention.
- The impact of surgical splenectomy on long-term infectious complication rates in pediatric SCD patients remains a critical area of investigation.
Purpose of the Study:
- To determine the frequency of infectious complications in children with SCD following surgical splenectomy for acute splenic sequestration.
- To compare infection rates between children with SCD who underwent splenectomy and those who did not.
Main Methods:
- Retrospective cohort study of children with SCD born after 2002, monitored until July 2013.
- Patients were categorized into cases (surgical splenectomy for splenic sequestration) and controls (no splenic sequestration or surgery).
- Infectious complications (sepsis, meningitis, bacteremia, acute chest syndrome, pneumonia) were analyzed from medical records.
Main Results:
- The case group included 44 patients (mean splenectomy age 2.6 years) with a mean follow-up of 6.1 years.
- The control group comprised 69 patients with a mean follow-up of 7.2 years.
- No significant difference in infectious complications was observed between the splenectomy and control groups, despite all receiving pneumococcal conjugate vaccine.
Conclusions:
- Surgical splenectomy for splenic sequestration in children with SCD did not lead to a higher frequency of infectious complications within a 6-year follow-up period.
- These findings suggest that surgical splenectomy is a safe option regarding infectious risk in this specific pediatric SCD population.
- Further research could explore long-term outcomes beyond 6 years and the role of vaccination protocols.
Objective:
To evaluate the frequency of infectious complications in children with sickle cell disease (SCD) after surgical splenectomy for acute splenic sequestration crisis.
Methods:
Retrospective cohort of children with SCD who were born after 2002 and were regularly monitored until July 2013. Patients were divided into two groups: cases (children with SCD who underwent surgical splenectomy after an episode of splenic sequestration) and controls (children with SCD who did not have splenic sequestration and surgical procedures), in order to compare the frequency of invasive infections (sepsis, meningitis, bacteremia with positive blood cultures, acute chest syndrome and/or pneumonia) by data collected from medical records. Data were analyzed by descriptive statistical analysis.
Results:
44 patients were included in the case group. The mean age at the time of splenectomy was 2.6 years (1-6.9 years) and the mean postoperative length of follow-up was 6.1 years (3.8-9.9 years). The control group consisted of 69 patients with a mean age at the initial follow-up visit of 5.6 months (1-49 months) and a mean length of follow-up of 7.2 years (4-10.3 years). All children received pneumococcal conjugate vaccine. No significant difference was observed between groups in relation to infections during the follow-up.
Conclusions:
Surgical splenectomy in children with sickle cell disease that had splenic sequestration did not affect the frequency of infectious complications during 6 years of clinical follow-up.
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