Hereditary spherocytosis and partial splenectomy in children: review of surgical technique and the role of imaging

2010 ◽  
Vol 40 (7) ◽  
pp. 1177-1183 ◽  
Author(s):  
Caroline L. Hollingsworth ◽  
Henry E. Rice
2009 ◽  
Vol 02 ◽  
pp. 9
Author(s):  
Elisabeth T Tracy ◽  
Henry E Rice ◽  
◽  

Partial splenectomy is an alternative to total splenctomy for the treatment of children with hereditary spherocytosis (HS) and other congenital hemolytic anemias. Total splenectomy effectively controls the symptoms of the disease, but places children at risk for overwhelming postsplenectomy sepsis (OPSI), as well as other severe complications. A growing body of data suggests that partial splenectomy provides acceptable hematological outcomes compared with total splenectomy while preserving splenic function. In this article we briefly review the rationale for partial splenectomy, parameters to evaluate splenic function, and recent clinical data on outcomes after partial splenectomy. Although many questions remain regarding the role of partial splenectomy, it may be a promising alternative to total splenectomy in children with HS and other congential hemolytic anemias.


2020 ◽  
Vol 41 (1) ◽  
pp. 59-71 ◽  
Author(s):  
Torsten Schlosshauer ◽  
Marcus Kiehlmann ◽  
Diana Jung ◽  
Robert Sader ◽  
Ulrich M Rieger

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4


Pathogens ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1436
Author(s):  
Giorgio Attina’ ◽  
Silvia Triarico ◽  
Alberto Romano ◽  
Palma Maurizi ◽  
Stefano Mastrangelo ◽  
...  

The spleen is a secondary lymphoid organ that belongs to the reticular-endothelial system, directly connected to blood circulation. The spleen is greatly involved in the immune response, especially against capsulated bacteria. Splenectomy plays a fundamental role in the treatment of numerous pediatric hematologic disorders. Taking into account all the possible complications (especially infections) linked to this procedure, alternatives to total splenectomy have been sought. Partial splenectomy has been proposed as a treatment that allows the reduction of infectious risk. This approach has proven safe and feasible in most patients, but multicentric and prospective studies are necessary to more accurately define the indications for performing partial splenectomy. However, vaccinations and antibiotic prophylaxis remain fundamental for preventing serious infections, even in the case of partial splenectomy. We review anatomical and functional properties of the spleen, with a focus on medical or surgical indications to splenectomy, aiming to give practical educational information to patients and their families after splenectomy. Furthermore, we discuss the feasibility of partial splenectomy in children with hematologic diseases who require splenectomy.


Videourology ◽  
2020 ◽  
Vol 34 (1) ◽  
Author(s):  
Marcelo Esteves Chaves Campos ◽  
Rodrigo Lolli Almeida Salles ◽  
Augusto Barbosa Reis ◽  
Reginaldo Martello ◽  
Thiago Pardini Furtado ◽  
...  

2004 ◽  
Vol 18 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Giuseppe Crescenzi ◽  
Anna Mara Scandroglio ◽  
Federico Pappalardo ◽  
Giovanni Landoni ◽  
Valeria Cedrati ◽  
...  

Neurosurgery ◽  
1989 ◽  
Vol 24 (4) ◽  
pp. 616-625 ◽  
Author(s):  
James R. Doty ◽  
Jeffrey Thomson ◽  
Gary Simonds ◽  
Setti S. Rengachary ◽  
E. Neal Gunby

ABSTRACT We evaluated four patients who had occult intrasacral meningocele with multimodality radiographic imaging techniques. The clinical features, radiological findings, gross appearances of the lesion at surgery, surgical technique, histopathological features of the cyst wall, and surgical outcome are described. The role of magnetic resonance imaging in the preoperative evaluation compared with standard radiographic techniques is discussed. Theories regarding the pathogenesis of this lesion are reviewed.


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