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Total versus partial splenectomy in pediatric hereditary spherocytosis: A systematic review and meta‐analysis
Author(s) -
Guizzetti Leonardo
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26106
Subject(s) - hereditary spherocytosis , medicine , splenectomy , spherocytosis , observational study , meta analysis , sepsis , pediatrics , surgery , spleen
Abstract To compare the clinical effectiveness of total splenectomy (TS) or partial splenectomy (PS) in pediatric hereditary spherocytosis, a systematic review and meta‐analysis was performed (PROSPERO registration CRD42015030056). There were 14 observational studies comparing pre‐ and postoperative hematologic parameters. Secondary outcomes include in‐hospital infections, surgical complications, symptomatic recurrence, and biliary disease. TS is more effective than PS to increase hemoglobin (3.6 g/dl vs. 2.2 g/dl) and reduce reticulocytes (12.5% vs. 6.5%) after 1 year; outcomes following PS are stable for at least 6 years. There were no cases of overwhelming postsplenectomy sepsis. A population‐based patient registry is needed for long‐term follow‐up.