Partial splenectomy in children: Long-term reoperative outcomes | 25 PATIENTS scheduled for partial splenectomy | 54% male | 100% white | 17 years | Single institution retrospective study on patients who underwent a successful partial splenectomy (PS). | Median age - 6.0 years | follow-up time 8.0 years | hereditary spherocytosis (HS) (n=21) | splenomegaly (n=2) | hereditary pyropoikilocytosis (HPP) (n = 1) | Cholecystectomy rates in the 21 HS patients | 33.3% at the time of PS. | 4.8% prior to PS. | 23.8% delayed procedure. | Later completion splenectomy performed: | 29% of all patients at median 34 months | 24% of those with HS at median 45 months | Conclusion: Partial splenectomy is a safe alternative to total splenectomy in children with hematologic disease. | https://pubmed.ncbi.nlm.nih.gov/33468309/ | Source: Indiana University School of Medicine, Indianapolis, IN | @StayCurrentMD | @EmTombash @emencisco @RodGerardo
Partial splenectomy in children: Long-term reoperative outcomes
Infographic · Dec 2021 · 1 min read
In brief
In brief
This 17-year retrospective study of 24 pediatric partial splenectomy patients found 29% required completion splenectomy at median 34 months, with no OPSS cases. Among hereditary spherocytosis patients, 39% needed delayed cholecystectomy if not performed initially, though no preoperative factors predicted reoperation risk.
- Partial splenectomy carries 29% reoperation rate to completion splenectomy at median 34 months follow-up in pediatric hematologic disease.
- Hereditary spherocytosis patients have 39% risk of delayed cholecystectomy if not performed with initial partial splenectomy.
- No preoperative factors (age, spleen size, hematologic parameters) predicted need for completion splenectomy in this cohort.
- Zero cases of OPSS or mortality observed, supporting safety profile of partial splenectomy approach in children.
- Families require counseling on substantial reoperation risk when choosing partial over total splenectomy for hematologic disorders.
Written by the GCMD Library team from the infographic.
The infographic uses a teal, white, and yellow color scheme with illustrated icons including a calendar, diverse children, red blood cells, and a gallbladder. Data is presented in sections with large percentage statistics in yellow and teal, organized in a grid layout with clear visual hierarchy.
Purpose: Partial, or subtotal, splenectomy (PS) has become an accepted alternative to total splenectomy (TS) for management of hematologic disorders in children, but little is known about its long-term out- comes. Here, we present our institutional experience with partial splenectomy, to determine rate of sub- sequent TS or cholecystectomy and identify if any factors affected this need.
Methods: All patients who underwent partial splenectomy at a single tertiary children’s hospital were retrospectively reviewed from 2002 through 2019 after IRB approval. Primary outcome of interest was rate of reoperation to completion splenectomy (CS) and rate of cholecystectomy. Secondary outcome were positive predictor(s) for these subsequent procedures.
Results: Twenty-four patients underwent PS, at median age 6.0 years, with preoperative spleen size of 12.7 cm by ultrasound. At median follow up time of 8.0 years, 29% of all patients and 24% of hereditary spherocytosis (HS) patients underwent completion splenectomy at median 34 months and 45 months, re- spectively. Amongst HS patients who did not have a cholecystectomy with or prior to PS, 39% underwent a delayed cholecystectomy following PS. There were no significant differences in age at index procedure, preoperative splenic volume, weight of splenic specimen removed, transfusion requirements, preoperative or postoperative hematologic parameters (including hemoglobin, hematocrit, total bilirubin, and reticulo- cyte count) amongst patients of all diagnoses and HS only who underwent PS alone compared to those who went on to CS. There were no cases of OPSS or deaths.
Conclusion: Partial splenectomy is a safe alternative to total splenectomy in children with hematologic disease with theoretical decreased susceptibility to OPSS. However, families should be counseled of a 29% chance of reoperation to completion splenectomy, and, in HS patients, a 39% chance of delayed cholecys- tectomy if not performed prior to or with PS. Further studies are needed to understand predictors of these outcomes.