Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Englum Brian R, Rothman Jennifer, Leonard Sarah, Reiter Audra, Thornburg Courtney, Brindle Mary, Wright Nicola, Heeney Matthew M, Jason Smithers C, Brown Rebeccah L, Kalfa Theodosia, Langer Jacob C, Cada Michaela, Oldham Keith T, Scott J Paul, St Peter Shawn D, Sharma Mukta, Davidoff Andrew M, Nottage Kerri, Bernabe Kathryn, Wilson David B, Dutta Sanjeev, Glader Bertil, Crary Shelley E, Dassinger Melvin S, Dunbar Levette, Islam Saleem, Kumar Manjusha, Rescorla Fred, Bruch Steve, Campbell Andrew, Austin Mary, Sidonio Robert, Blakely Martin L, Rice Henry E, Splenectomy in Congenital Hemolytic Anemia Consortium
Аннотация
METHODS: The Splenectomy in Congenital Hemolytic Anemia (SICHA) consortium registry collected hematologic outcomes of children with CHA undergoing TS or PS to 1 year after surgery. Using random effects mixed modeling, we evaluated the association of operative type with change in hemoglobin, reticulocyte counts, and bilirubin. We also compared laparoscopic to open splenectomy.
RESULTS: The analysis included 130 children, with 62.3% (n=81) undergoing TS. For children with HS, all hematologic measures improved after TS, including a 4.1g/dl increase in hemoglobin. Hematologic parameters also improved after PS, although the response was less robust (hemoglobin increase 2.4 g/dl, p<0.001). For children with SCD, there was no change in hemoglobin. Laparoscopy was not associated with differences in hematologic outcomes compared to open. TS and laparoscopy were associated with shorter length of stay.
CONCLUSION: Children with HS have an excellent hematologic response after TS or PS, although the hematologic response is more robust following TS. Children with SCD have smaller changes in their hematologic parameters. These data offer guidance to families and clinicians considering TS or PS.