Experience on children's splenectomy: a ten year single center retrospective study
DOI:
https://doi.org/10.51481/amc.v60i4.1015Keywords:
splenectomy, complications, antibiotic profilaxis, inmunization, children, Costa Rica, Latinamerica, CentralmericaAbstract
Aim: to describe clinical characteristics and evolution of patients who underwent splenectomy in Costa Rica's National Children's Hospital during January 1996 through December 2006.
Methods: This is a chart review study in a 10 year period including children who underwent splenectomy. A hundred and seven charts of children with ages between 0 and 18 years old were reviewed to obtain their clinical presentation, characteristics, indications for splenectomy, follow up, complications and mortality. Also the antibiotic prophylaxis and immunization schedule was analyzed based on international recommendations.
Results: A total of 107 patients were included. Results showed that the mean age at which splenectomy was performed was 6.4 years. Most of the patients had their splenectomy due to hemoglobinophaties (59.8%), followed by immune thrombocytopenic purpura (16.8%) and malignant osteopetrosis (8.4%). The most common indications for splenectomy were treatment of the disease (39.9%), hyperesplenism (26.2%) and lack of responde to medical treatment (22.4%). Laparotomy was the most performed surgery (87.9%). Mainly sepsis and hemorrhage were found as complications due to procedure. Overall, complete response to surgical treatment was observed (66.7%). Five patients died during follow up.
Conclusions: Splenectomy is an alternative for treating medical disease with predominantly good outcomes observed in our study.
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References
Spencer T. Remarks on Splenectomy, with a report of a successful case. Med Chir Trans. 1888; 71:255-263.
Al-Salem A. Splenectomy for children with Thalassemia: Total or partial splenectomy, open or laparoscopic splenectomy. J Pediatr Hematol Oncol 2016;38:1-4
Davies JM, Barnes R y Milligan D, Update of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen. Clin Med JRCPL 2002;2:440-3
Roy S, Buchanan G y Crary S. Splenectomy in children with ""mild"" hereditary spherocytosis. J Pediatr Hematol Oncol 2013;35:430-433
Monaco C, Belintani Blum Fonseca P y Pellegrini Braga J. Complicaciones infecciosas en niños con enfermedad falciforme después de esplenectomía quirúrgica. Rev Paul Pediatr. 2015;150-153
Gokarn N, Manwani D, Friedmann P, Borenstein S, Jan D y Renaud E. Outcomes after early splenectomy for hematological disorders. J Laparoendosc Adv Surg Tech A. 2014;24:1-4.
Al-Salem AH. Splenectomy for children with Thalassemia: Total or partial splenectomy, open or laparoscopic splenectomy. J Pediatr Hematol Oncol 2016; 38:1-4.
Bell R, Boswell T, Hui T y Su W. Single-incision laparoscopic splenectomy in children. Journal of Pediatric Surgery,2012;47, 898-903.
Das A, Bansal D, Das R, Trehan A y Marwaha RK. Hereditary spherocytosis in children: profile and post-splenectomy outcome. Indian Pediatrics. 2014; 51:139-141
Rice H, Crary S, Langer J y Kemper A. Comparative effectiveness of different types of splenectomy for children with congenital hemolytic anemias. Journal of Pediatrics. 2012; 160:684-689
Lammers A. J. J., Veninga D, Lombarts M. J. M. H., Hoekstra J. B. L. y Speelman D. Management of post-splenectomy patients in the Netherlands. Eur J Clin Microbiol Infect Dis. 2010;29:399-405
Overturf G. Technical report: prevention of pneumococcal infections, including the use of pneumococcal conjugate and polysaccharide vaccines and antibiotic prophylaxis. Pediatrics. Vol. 106 No. 2 August 2000:367-376.
AAP. Recommended Immunization Schedule for children and adolescents aged 18 years or younger, United States 2017. www.aap.org
Alter S. Pneumococcal infections. Pediatrics in Review. Vol 30. No5. 2009: 155-163.
Schifferli A y Kühne T. Chronic immune thrombocytopenia in children: who needs splenectomy? Seminars in Hematology, 2013:58-62
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