Total versus partial splenectomy in pediatric hereditary spherocytosis: A systematic review and meta-analysis.
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.
Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
Leonardo
L
Guizzetti
D002648:Child; D006801:Humans; D017594:Publication Bias; D011788:Quality of Life; D017701:Reticulocyte Count; D013103:Spherocytosis, Hereditary / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects
hemolytic anemia; hereditary spherocytosis; splenectomy