Our Summary

This study analyzed the results of a surgical procedure, either total or partial removal of the spleen (splenectomy), in children suffering from a blood disorder called hereditary spherocytosis. The surgery is often necessary for patients who have severe anemia or frequently experience specific types of health crises. Between 2009 and 2012, fifteen patients, ages 4-17, underwent this surgery, with some undergoing partial removal and others complete removal of the spleen.

The researchers tracked various health indicators like blood counts, liver function, and spleen size before and after surgery. Hospital stays and surgery times were similar for both groups. The blood supply was better in the partial removal group due to certain arteries. Both groups saw improvements in blood health measures following the surgery.

One notable change was that platelet count (an important factor in blood clotting) rose significantly after the surgery and stayed high for six months, then gradually returned to normal. Bilirubin (a substance produced by the liver that can indicate certain health issues) levels dropped right after surgery, rose slightly, but remained lower than before the surgery. No serious infections were observed in either group.

The research concluded that both total and partial removal of the spleen improved health indicators. However, they also noted that a larger study group and longer follow-up period would be necessary to fully assess the outcomes.

FAQs

  1. What is the purpose of a splenectomy in children with hereditary spherocytosis?
  2. What were the main findings of the study regarding the effects of total and partial splenectomy on health indicators?
  3. Were there any significant differences observed in hospital stays or surgery times between the group that underwent total removal of the spleen and the group that underwent partial removal?

Doctor’s Tip

A helpful tip a doctor might give a patient about splenectomy is to stay vigilant about monitoring their health after the surgery, including regular blood tests to ensure that blood counts and other health indicators remain stable. It is also important to be aware of the potential risks of infection after splenectomy and to take precautions such as receiving vaccinations for certain infections, like pneumonia and meningitis, as recommended by their healthcare provider. Lastly, it is important to communicate any concerning symptoms or changes in health to their doctor promptly.

Suitable For

Patients who are typically recommended for splenectomy include those with:

  1. Hereditary spherocytosis: A genetic blood disorder that causes red blood cells to be abnormally shaped, leading to anemia and other health issues.

  2. Severe anemia: Where the body lacks enough healthy red blood cells to carry adequate oxygen to tissues throughout the body.

  3. Frequent health crises: Such as hemolytic crises, where red blood cells are destroyed faster than they can be produced, leading to symptoms like fatigue, jaundice, and an enlarged spleen.

  4. Thrombocytopenia: A condition where there is a low platelet count, increasing the risk of excessive bleeding and bruising.

  5. Enlarged spleen: Known as splenomegaly, which can cause pain, fatigue, and other complications.

  6. Autoimmune disorders: Where the immune system mistakenly attacks healthy cells and tissues, leading to various health issues.

  7. Certain types of cancers: Such as lymphomas or leukemias that affect the blood cells and immune system.

Overall, splenectomy may be recommended for patients with specific blood disorders or health conditions that can be improved by removing or reducing the function of the spleen.

Timeline

Before splenectomy, patients may experience symptoms such as severe anemia, frequent health crises, and enlarged spleen. They may undergo various tests to assess their blood counts, liver function, and spleen size. Following the surgery, patients may experience improvements in blood health measures, including increased platelet count and decreased bilirubin levels. The hospital stay and surgery time are similar for both total and partial removal of the spleen. A longer follow-up period and a larger study group are needed to fully assess the outcomes of splenectomy in patients with hereditary spherocytosis.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with splenectomy?
  2. How will my immune system be affected by the removal of my spleen?
  3. Will I need to take any medications or supplements after the surgery?
  4. How long will it take to recover from the surgery and when can I return to normal activities?
  5. Will I need any follow-up appointments or tests after the surgery?
  6. How will my blood counts and liver function be monitored post-surgery?
  7. Are there any lifestyle changes I should consider after having a splenectomy?
  8. How will the surgery impact my ability to fight off infections in the future?
  9. Are there any long-term effects of having a splenectomy that I should be aware of?
  10. What should I do if I experience any complications or side effects after the surgery?

Reference

Authors: Rogulski R, Adamowicz-Salach A, Matysiak M, Piotrowski D, Gogolewski M, Piotrowska A, Roik D, Kamiński A. Journal: Eur J Haematol. 2016 Jun;96(6):637-42. doi: 10.1111/ejh.12649. Epub 2015 Sep 17. PMID: 26268883