Abstract
The spleen is a secondary lymphoid organ that belongs to the reticular-endothelial system, directly connected to blood circulation. The spleen is greatly involved in the immune response, especially against capsulated bacteria. Splenectomy plays a fundamental role in the treatment of numerous pediatric hematologic disorders. Taking into account all the possible complications (especially infections) linked to this procedure, alternatives to total splenectomy have been sought. Partial splenectomy has been proposed as a treatment that allows the reduction of infectious risk. This approach has proven safe and feasible in most patients, but multicentric and prospective studies are necessary to more accurately define the indications for performing partial splenectomy. However, vaccinations and antibiotic prophylaxis remain fundamental for preventing serious infections, even in the case of partial splenectomy. We review anatomical and functional properties of the spleen, with a focus on medical or surgical indications to splenectomy, aiming to give practical educational information to patients and their families after splenectomy. Furthermore, we discuss the feasibility of partial splenectomy in children with hematologic diseases who require splenectomy.
Highlights
Splenectomy is still fundamental in the treatment of numerous pediatric hematologic and immunological disorders
The main indications for splenectomy are represented by congenital hemolytic anemia, some forms of thalassemia, idiopathic thrombocytopenic purpura not responsive to medical treatment, and some forms of accumulation disease associated with hypersplenism (Gaucher’s disease, Niemann-Pick’s disease) [1]
We review anatomical and functional properties of the spleen, performing a focus on medical or surgical indications to splenectomy, with the aim to give a practical educational guide to patients and their families after splenectomy
Summary
Splenectomy is still fundamental in the treatment of numerous pediatric hematologic and immunological disorders. There are surgical indications, such as the presence of splenic tumors or cysts, abscesses, trauma with partial and or total rupture. In all these situations splenectomy plays a potentially resolving therapeutic option. It may be burdened by very important infectious and vascular complications that often limit its indication or therapeutic success [2,3]. We discuss the opportunity of partial splenectomy that in recent years has been considered to be a feasible alternative to radical splenectomy in order to obtain a clinical resolution, reducing or eliminating the infectious risks related to the absence of the spleen, which plays an important role in the immune response, especially against capsulated bacteria
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
