Acute chest syndrome after splenectomy in children with sickle cell disease

Ghantous, S.; Mulhim, Saad Al; Faris, Nafeesa Al; Abushullaih, Basel A.; Shalak, Firas; Yazbeck, Salam

doi:10.1016/j.jpedsurg.2007.12.025

Cited by 19 publications

(14 citation statements)

References 10 publications

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“…In children with sickle-cell crisis, splenectomy may be considered after the crisis has been abated by transfusion and medical treatment. The immediate risks seem similar to those associated with other indications for benign haematological disorders, but the long-term outcome is burdened by many vascular complications (Kokoska et al, 2004;Ghantous et al, 2008;Kalpatthi et al, 2010). Advice from expert centres is recommended.…”

Section: Haemolytic Anaemias and Red Blood Cell Disorders With Enhancmentioning

confidence: 98%

Short‐ and long‐term risks of splenectomy for benign haematological disorders: should we revisit the indications?

2012

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SummarySplenectomy has represented a key treatment option in the treatment of many benign haematological diseases, including immune thrombocytopenia (ITP) and disorders associated with ongoing haemolysis (thalassaemia major and intermedia, sickle cell disease, and hereditary or acquired haemolytic anaemias). Improvements in surgical techniques have reduced perioperative complications and mortality. Preventive measures (new protein conjugate vaccines, antibiotic prophylaxis, and increased vigilance) are thought to greatly reduce the risk of overwhelming post-splenectomy infection (OPSI), although their implementation is inconsistent. Nevertheless, there is increasing documentation of the short-and long-term risks of splenectomy, which vary according to the underlying indication. Splenectomized patients are at increased risk of venous thromboembolism, particularly within the splenoportal system. The long-term thromboembolic risk is higher in haematological disorders associated with ongoing haemolysis, particularly in thalassaemia intermedia, which has led to a more conservative approach. In comparison, patients with ITP appear to be at lower risk of adverse effects of splenectomy, which maintains its place as the potentially most curative and safe second-line treatment. However, a splenectomy-sparing approach is also emerging for ITP, and recent guidelines recommend that this procedure is deferred until 12 months from ITP diagnosis, to allow sufficient time for possible remission.

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Section: Haemolytic Anaemias and Red Blood Cell Disorders With Enhancmentioning

confidence: 98%

Short‐ and long‐term risks of splenectomy for benign haematological disorders: should we revisit the indications?

2012

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“…Common risk factors for the development of ACS include younger age, lower hemoglobin F concentration, higher steady state hemoglobin concentration, and white blood cell count [2]. Incidence of ACS after splenectomy has been reported between 20 and 33 % by Ghantous and al with no evidence of benefit between a laparoscopic and open approach [3]. The aim of the study was to define the incidence of ACS after laparoscopic splenectomy on patients with SCD to determine the patients at higher risk of such post operative complication suggesting a post operative surgical management.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2014

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“…Intensive care unit admission is inconsistent across studies with some authors suggesting the benefits of systematic postoperative admission into intermediate/intensive care units, some retaining no indication for ICU admission, and others recommending case‐by‐case decision‐making …”

Section: Resultsmentioning

confidence: 99%

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

et al. 2019

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Children with sickle cell disease (SCD) require specific perioperative care, and clinical practice in this area remains poorly defined. We aimed to conduct a systematic, PRISMA-based review of the literature, available clinical guidelines and practice recommendations. We also aimed to extract any valuable information for the "best of available-evidence"-based prevention of perioperative adverse events in children with SCD, and highlight the most urgent priorities in clinical research. As data sources, USWe also included institutional, consortia and expert group guidelines. Included were reports/guidelines in English, French, German, and Italian. Excluded were reports on obstetrical and fetal management. We identified 202 reports/guidelines fulfilling the criteria outlined above. A majority focused on visceral, cardiovascular and orthopedic surgery procedures, and only five were multicenter randomized controlled trials and two prospective randomized studies. After grading of the quality of the evidence, the extracted data was summarized into clinical recommendations for daily practice. Additionally, we designed a risk-grading algorithm to identify contexts likely to be associated with adverse outcomes. In conclusion, we provide a systematic PRISMA-based review of the existing literature and ancillary practice and delineate a set of clinical recommendations and priorities for research.

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Acute chest syndrome after splenectomy in children with sickle cell disease

Cited by 19 publications

References 10 publications

Short‐ and long‐term risks of splenectomy for benign haematological disorders: should we revisit the indications?

Short‐ and long‐term risks of splenectomy for benign haematological disorders: should we revisit the indications?

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

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

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