Clinical and hematologic outcomes after splenectomy for congenital hemolytic anemia

Abstract

Aim The aim was to delineate clinical and hematological outcomes of splenectomy in congenital hemolytic anemia patients. Patients and methods It was a retrospective descriptive study in the Pediatric Hematology Ward involving patients aged 4–18 years from 2010 to 2016. Data were collected using a structured questionnaire and analyzed using the Statistical Package for the Social Sciences, Version 20. Results The study was performed on 104 patients, 60 males and 44 females, age range 4–18 years. The mean age was 9.19 ± 3.33. Postoperative complications developed in 26% of patients, mostly wound infection, hematological parameters, especially hemoglobin level, are elevated after splenectomy and is equal to 6.74 ± 1.27 g% in most patients. Splenectomy decreases blood transfusion needs to 50% of the presplenectomy stage and increases the interval in between blood transfusion after splenectomy to the double. Conclusion Splenectomy to the children who suffered from congenital hemolytic anemia such as beta thalassemia major, sickle cell anemia and spherocytosis improved hematological parameters, especially hemoglobin level, so the number of blood transfusions and hospital admissions decreased that improved the quality of life. On the other side, there are early and late postoperative complications which can be avoided by proper perioperative vaccination and taking postoperative 2-weekly long-acting penicillin. Rationale Identify the clinical and hematological outcomes of splenectomy in children due to hematological disorders, especially β-thalassemia major. In the locality splenectomy is still one of the most important modalities used in the partial treatment of chronic hemolytic anemia.