[Splenectomy in children; indications and surgical aspects].
There are no hard indications for splenectomy in children. The single most generally accepted indication is the more severe form of congenital spherocytosis. Idiopathic thrombocytopenia purpura is only an indication if there is a severe bleeding tendency. Other than local conditions involving the spleen, there seem to be no good indications for partial splenectomy. Ablation by means of embolisation has not gained popularity. Laparoscopic splenectomy appears to be better than splenectomy via laparotomy, but sound scientific evidence for this is not yet available. There appears to be an increased incidence of portal vein thrombosis immediately after splenectomy. The value of thrombosis prophylaxis has not yet been investigated.
Jansen
M J C E
MJ
Afd. Kinderchirurgie, Universitair Medisch Centrum, Wilhelmina Kinderziekenhuis, Postbus 85.090, 3508 AB Utrecht.
Bax
N M A
NM
Révész
T
T
Sanders
E A M
EA
D002648:Child; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D011169:Portal Vein; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery; D013103:Spherocytosis, Hereditary / Q000601:surgery; D013154:Spleen / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects* / Q000379:methods; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control; D016896:Treatment Outcome