Clinical research on partial splenic artery embolization in treatment of hereditary spherocytosis in children

Abstract

Objective: To assess the clinical therapeutic effect of partial splenic artery embolization (PSE) in the treatment of hereditary spherocytosis (HS) in children. Methods: A total of 38 children suffering from HS received PSE in our hospital from 2000 to 2015 were selected and treated by PSE, using Seldinger technique and 150~350 μm gelatin sponge particles. The clinical manifestations, peripheral blood picture, spleen contraction, liver function improvement and immune function were compared before and after PSE. Results: In all 38 cases, spleen was reduced to a certain extent in the follow-up visits in 1, 3, 6 months and 1, 3, 5 years. In 33 cases complete response was achieved, and in 4 cases partial response was achieved. In 1 case, an accessory spleen was formed. After the operation, the patients’s development and nutritional status were improved significantly. Notable recovery could be observed both in hemoglobin (Hb) and red blood cells. Liver function returned to normal. Unconjugated bilirubin decreased to normal with no rise. The difference of serum immunoglobulin levels 1~3 years after the operation was not statistically significant (P>0.05) . One early case encountered splenic abscess after operation and recovery was achieved after receiving treatment based on symptoms. There was no occurrence of serious complications such as splenic vein thrombosis, lower extremity arteriovenous thrombosis, splenic rupture and so on in all 38 cases. Conclusions: PSE has obvious effect in treating HS in children, with minimal operative wound and few complication. It can not only achieve similar effect as splenectomy, but also enjoy the advantage of preserving the immune function of spleen, PSE, as the preferred method to treat HS in children, is worthy of clinical application and promotion. Key words: Splenic embolization; Hereditary spherocytosis; Children