Long-term outcomes after pediatric splenectomy

Surgery
Topi T LuotoAntti Koivusalo

Abstract

Splenectomy is performed frequently for various and primarily hematologic indications in children and adolescents. We analyzed the long-term outcome after splenectomy (median, 8.7 years) focusing on sepsis, portal vein thrombosis (PVT), and retained accessory spleen. In total, 141 consecutive children after open (n = 89; 63%) or laparoscopic (n = 52; 37%) splenectomy from 1991 to 2010 were followed up through nationwide registries for septic infections, PVT, and causes of death. Sixty-six patients (58% of survivors) answered a structured questionnaire on infections, abdominal symptoms, and general health, and 64 (laparoscopic n = 26, open n = 38) consented to ultrasonography of the portal venous system. Median operation age was 8.8 years (range, 1.0-22). Reoperations were required for bleeding after open procedures (n = 1) and retained accessory spleen after laparoscopic procedures (n = 3). Postsplenectomy sepsis occurred after a median of 1.7 years (range, 0.2-5.9) in 11 patients (8%), of whom 10 had an underlying immunodeficiency. No cases of PVT were observed, although the median portal vein flow was 1,130 mL/min (range, 440-2200) and diameter was 9.9 mm (range, 7-15) at a median follow-up of 9.5 years (range, 2.0-22) after ...Continue Reading

References

Aug 12, 1999·Journal of Pediatric Surgery·M JugenburgS H Ein
May 17, 2000·Journal of Pediatric Surgery·R K MinkesJ C Langer
Mar 23, 2006·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Fabrizio RomanoFranco Uggeri
Sep 26, 2007·Annals of Surgery·Frederick J RescorlaJay L Grosfeld
May 20, 2008·Journal of Pediatric Surgery·Maciej MurawskiJózef Dzielicki
Jan 24, 2009·Surgical Endoscopy·Abdulmalik M S AltafDennis Klassen
Dec 31, 2010·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Rosario VecchioEva Intagliata
Mar 5, 2011·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Nadire Unver DoganGiray Kolcu
May 11, 2012·British Journal of Haematology·Francesco Rodeghiero, Marco Ruggeri
Jan 16, 2013·JSLS : Journal of the Society of Laparoendoscopic Surgeons·Vadim P KoshenkovMitchel S Carter
Dec 18, 2013·Journal of Thrombosis and Thrombolysis·Thomas GelasPierre-Yves Mure
Jan 1, 2014·Annals of Surgery·Gustaf EdgrenGarth H Utter
Jul 24, 2014·The New England Journal of Medicine·Lorry G Rubin, William Schaffner

❮ Previous
Next ❯

Citations

Jan 28, 2017·Journal of the American College of Surgeons·David S SilverDouglas P Slakey

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cancer Imaging

Imaging techniques, including CT and MR, have become essential to tumor detection, diagnosis, and monitoring. Here is the latest research on cancer imaging.