Partial splenectomy in children: Long-term reoperative outcomes^☆

Area of Science:

• Pediatric Surgery
• Hematology
• Surgical Outcomes

Background:

• Partial splenectomy (PS) is an alternative to total splenectomy (TS) for pediatric hematologic disorders.
• Long-term outcomes of PS, including reoperation and cholecystectomy rates, are not well-established.

Purpose of the Study:

• To evaluate the institutional experience with PS in children.
• To determine the rates of subsequent completion splenectomy (CS) and cholecystectomy after PS.
• To identify factors influencing the need for these subsequent procedures.

Main Methods:

• Retrospective review of pediatric patients undergoing PS from 2002-2019.
• Primary outcomes: rates of CS and cholecystectomy.
• Secondary outcomes: predictors for subsequent procedures.

Main Results:

• 24 patients underwent PS; median follow-up was 8.0 years.
• 29% of all patients and 24% of hereditary spherocytosis (HS) patients required CS.
• 39% of HS patients without prior/concurrent cholecystectomy underwent delayed cholecystectomy.

Conclusions:

• PS is a safe alternative to TS in pediatric hematologic disease, potentially reducing OPSS risk.
• Counseling is essential regarding a 29% risk of CS and a 39% risk of delayed cholecystectomy in HS patients.
• Further research is needed to identify predictors for these outcomes.