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ORIGINAL ARTICLE
Year : 2018  |  Volume : 31  |  Issue : 1  |  Page : 118-125

Role of splenectomy inthalassemicpatients


1 Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of General Surgery, Mansoura New General Hospital, Mansoura, Egypt

Correspondence Address:
Ashraf N Mohammed
Department of General Surgery, Mansoura New General Hospital, Mansoura
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.234219

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Objective Theobjectiveof this study was to evaluate the role of splenectomy in decreasing the transfusion needs in thalassemia patients. Background Thalassemia can cause significant complications, including iron overload, bone deformities, and cardiovascular illness. In thalassemia, spleen is the most commonlyaffectedorgan as seen from the incidence of splenomegaly, due to excessive destruction of abnormal red blood cells, extramedullary hematopoiesis, and transfusional overload. Patients and methods This investigation is designed as a prospective study in which 15patients with thalassemia major underwent splenectomy under both open and laparoscopic techniques. Patients were selected from the outpatient clinic of the General Surgery Department and were followed up for 1year after surgery. Results Patients underwent open splenectomy(47%) and laparoscopic splenectomy(53%). The operative complications were bleeding(13%) and injury to the spleen during port insertion(6%). After splenectomy, the patients were followed up for 1year. All patients showed an improvement in hemoglobin and hematocrit levels. Also, all the blood elements–red blood cells, white blood cells, and platelets–showed a significant increase after splenectomy in all patients. Conclusion Splenectomy definitively reduced blood requirements for thalassemia patients from twice every month preoperatively to less than once per month, with improved hemoglobin levels. These improvements are sustained over a prolonged period of time.


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