Surgical and anaesthetic outcomes of paediatric splenectomies at a tertiary care institution in South India: a retrospective cohort
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Jul 2022 · 1 min read
In brief
In brief
Retrospective analysis of 69 pediatric splenectomies over 5 years at a South Indian tertiary center, primarily for thalassemia and ITP. Study identifies pre-operative transfusion requirements, spleen size, and intraoperative fluid volume as predictors of surgical complexity, with overall excellent outcomes (98.5% survival, no OPSI).
Written by the GCMD Library team from the article.
Abstract
Purpose
Splenectomies though well-established in the successful management of several resistant haemoglobinopathies, have not been studied in detail in the paediatric population to assess the outcomes. We conducted this review to primarily assess the surgical and anaesthetic outcomes of paediatric splenectomies and secondarily highlight factors predictive for a high-risk splenectomy.
Methods
A 5 year retrospective chart review was made, and patient follow-up was done jointly using the hospital electronic medical records and telephonic calls. A p value of < 0.05 was considered significant.
Results
Among the 69 splenectomised children, 61% were male and the overall mean age was 10.2 years. The cohort consisted of patients with thalassemia (46%), ITP (30%), haemolytic anemia (19%) and 1 child each with lymphoma, splenic cyst and Kassabach Meritt syndrome. Most (96%) were electively operated and 23% were performed laparoscopically. 61% received intravenous analgesia and the mean volume of fluid administered intra-operatively was 21 ml/kg. There was no documented OPSI, and there was one mortality. The mean follow-up period was 43 months and the overall survival rate was 98.5%.
Conclusions
Splenectomy was associated with a promising overall outcome. A greater pre-operative transfusion requirement, a larger sized spleen and increased fluid administration intra-operatively, were associated with a worse outcome.