Acute chest syndrome after laparoscopic splenectomy in children with sickle cell disease: operative time dependent?

Bonnard, A.; Masmoudi, Mahmoud; Boimond, B.; Capito, Carmen; Holvoet, Laurent; Skhiri, Alia; El-Ghoneimi, Alaa

doi:10.1007/s00383-014-3600-0

Cited by 6 publications

(9 citation statements)

References 8 publications

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“…In a recent retrospective study, Bonnard et al reported the incidence of ACS following a laparoscopic splenectomy to be 23%. 9 In the present study, the incidence of ACS was much lower (8%). Other serious postoperative complications include pancreatitis due to an injury to the tail of the pancreas during a laparoscopic splenectomy, with a reported incidence of up to 15%.…”

Section: 21contrasting

confidence: 53%

“…ACS was diagnosed according to previously described criteria. 9 Indications for splenectomies alone in children with SCD included either hypersplenism or acute splenic sequestration. Hypersplenism was defined as splenic enlargement with one of the following conditions: anaemia (requiring a transfusion of packed red blood cells exceeding 250 mL/kg per year); thrombocytopaenia (indicated by a platelet count of ≤100,000/mm 3 ); and neutropaenia (indicated by a white blood cell count of ≤4,000/mm 3 ).…”

Section: Methodsmentioning

confidence: 99%

“…[6][7][8] The management of paediatric patients with SCD can be challenging, as surgical procedures may precipitate a sickling crisis. 9 Paediatric SCD patients may require a splenectomy for various indications, such as recurrent splenic sequestration or splenic dysfunction. 10 The effectiveness of splenectomies in improving haematological outcomes is well-established.…”

mentioning

confidence: 99%

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Laparoscopic Splenectomy Alone for Sickle Cell Disease: Account of 50 paediatric cases

Al-Balushi

Bhatti

Ehsan

et al. 2016

SQUMJ

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Objectives: In Oman, the most frequent indication for a splenectomy in children is sickle cell disease (SCD), which is one of the most common haematological disorders in the Gulf region. This study aimed to describe paediatric laparoscopic splenectomies alone for SCD at a tertiary hospital in Oman. Methods: This study was conducted between February 2010 and October 2015 at the Sultan Qaboos University Hospital, Muscat, Oman. The medical records of all children aged ≤15 years old undergoing splenectomies during the study period were reviewed. Results: A total of 71 children underwent laparoscopic splenectomies during the study period; of these, 50 children (28 male and 22 female) underwent laparoscopic splenectomies alone for SCD. The children's weight ranged between 11-43 kg. The most common indication for a splenectomy was a recurrent splenic sequestration crisis (92%). Surgically removed spleens weighed between 155-1,200 g and measured between 9-22 cm. Operative times ranged between 66-204 minutes and intraoperative blood loss ranged between 10-800 mL. One patient required conversion to an open splenectomy. Postoperative complications were noted in only four patients. The median hospital stay duration was three days. Conclusion: Among this cohort, the mean operating time was comparable to that reported in the international literature. In addition, rates of conversion and postoperative complications were very low. These findings indicate that a laparoscopic splenectomy alone in paediatric patients with SCD is a feasible option.

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Section: 21contrasting

confidence: 53%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Laparoscopic Splenectomy Alone for Sickle Cell Disease: Account of 50 paediatric cases

Al-Balushi

Bhatti

Ehsan

et al. 2016

SQUMJ

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“…9,22,25 An overall morbidity of 19/150 cases (12.7%) is reported with ACS accounting for 11/150 (7.3%) .This morbidity rate after splenectomy is similar to other reports traced in the world literature. 11,12,16,18…”

Section: Discussionmentioning

confidence: 99%

Splenectomy in Jamaican children with sickle cell disease: Outcome of selective blood transfusion

Steele

Simms

et al. 2020

Trop Doct

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We reviewed the post-operative morbidity and mortality of open splenectomy undertaken in conjunction with selective blood transfusion in Jamaican children with sickle cell disease. Data were collected on 150 splenectomies performed between November 1994 and October 2017. Selective blood transfusion involved raising haemoglobin levels to approximately 100 g/L in patients with admission haemoglobin ≥10 g/L below steady state. There was no mortality. Mean post-operative stay was 3.2 days with a median of three days. Total morbidity was 19/150 cases (12.7%), with acute chest syndrome accounting for 11/19 (57.9%). Among the non-transfused, acute chest syndrome occurred in 10/117 cases (8.5%), while among transfused, acute chest syndrome occurred in 1/33 cases (2.9%). We recommend this selective blood transfusion protocol for patients with sickle cell disease to surgeons who undertake splenectomies in settings where blood bank reserves are perennially low.

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“…Reported complications for both open and laparoscopic splenectomy include intraoperative and postoperative bleeding, incision infection, pancreatic leak, rupture of the diaphragm, subphrenic hematoma, rupture of the colon, portal or splenic vein thrombosis, splenic hematoma, postoperative fever, acute chest syndrome and pulmonary complications, particularly in SCD children 2,6,7,9,27,28 . In our study, only one case of intraoperative bleeding was converted to laparotomy (a conversion rate of 2%), and postoperative pneumonia in 31% of patients.…”

Section: 96% Conversion To Openmentioning

confidence: 99%

Laparoscopic Splenectomy in Children with Sickle Cell Disease

Alhindi¹,

Ali²

2016

BMB

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Sickle Cell Disease (SCD) is a common genetic hematological disorder 1. The spleen is one of the early organs to be affected by SCD. Early in life, splenomegaly occurs, and with repeated vaso-occlusion and infarctions, auto splenectomy would follow; although splenomegaly could persist in some patients 2. Acute splenic sequestration, hypersplenism, splenic abscess and massive splenic infarction are serious SCD complications 2,3,4. Treatment could be either conservative with repeat transfusions or surgical. Splenectomy is indicated due to the high risk of recurrence and increased morbidity and mortality of some of the above-mentioned complications 2. The laparoscopic approach has been compared to open approach in multiple studies in children with SCD as well as other hematologic disorders, and has proven to be superior to the open approach 5-9. It has the advantages of decreased pain, shorter hospital stay, fewer complications, faster return to normal activities and better cosmetic outcome 5-11. Several techniques were practiced for laparoscopic splenectomy in children, some of which had been tried in SCD children because they require a rigorous management from their caregivers 10-17 .

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Acute chest syndrome after laparoscopic splenectomy in children with sickle cell disease: operative time dependent?

Abstract: ACS is an important complication following laparoscopic splenectomy in patients with SCD. The immediate post operative management, in the absence of predictive factors for ACS, should be carefully followed in a high dependency unit at least for 48 h for all patients.

Cited by 6 publications

References 8 publications

Laparoscopic Splenectomy Alone for Sickle Cell Disease: Account of 50 paediatric cases

Laparoscopic Splenectomy Alone for Sickle Cell Disease: Account of 50 paediatric cases

Splenectomy in Jamaican children with sickle cell disease: Outcome of selective blood transfusion

Laparoscopic Splenectomy in Children with Sickle Cell Disease

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