Tripodi Serena I, Shamberger Robert C, Heeney Matthew M, Tubman Venée N
Department of Pediatrics, University of Brescia , Brescia , Italy.
Department of Surgery, Boston Children's Hospital , Boston , Massachusetts , USA.
Pediatr Hematol Oncol. 2019 Sep;36(6):382-389. doi: 10.1080/08880018.2019.1637983. Epub 2019 Jul 26.
This study compared outcomes following total (TS) or partial splenectomy (PS) among patients with hereditary spherocytosis. Seventy-nine patients (TS = 33, PS = 46) were identified. The follow-up period was longer after PS (59.6 vs. 24.9 months, < .001). Long-term adverse events occurred more frequently following PS (50% vs. 29%, = .001). Anemia, jaundice, and fatigue recurred in six patients with PS, leading to five completion splenectomies. Hemoglobin was not different between PS and TS by 5 years post-procedure (12.3 vs. 13.4 g/dL, = .25). Both PS and TS ameliorate symptoms and improve hematologic parameters. The rate of secondary surgery following PS should be considered when planning the initial surgical procedure.
本研究比较了遗传性球形红细胞增多症患者行全脾切除术(TS)或部分脾切除术(PS)后的结局。共纳入79例患者(TS组33例,PS组46例)。PS组的随访期更长(59.6个月 vs. 24.9个月,P<0.001)。PS后长期不良事件的发生频率更高(50% vs. 29%,P = 0.001)。6例PS患者出现贫血、黄疸和疲劳复发,导致5例患者最终接受了全脾切除术。术后5年时,PS组和TS组的血红蛋白水平无差异(12.3 g/dL vs. 13.4 g/dL,P = 0.25)。PS和TS均能改善症状并改善血液学参数。在规划初始手术时,应考虑PS后的二次手术率。