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A laparoscopic approach to partial splenectomy for children with hereditary spherocytosis

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Abstract

Background

Partial splenectomy is sometimes used for children with hereditary spherocytosis (HS) to reduce hemolysis while retaining some splenic immune function. Previous reports have described a partial splenic resection through a laparotomy incision. Whereas laparoscopic total splenectomy for HS is well-established, laparoscopic partial splenectomy (LPS) has not been described. The authors have developed a novel LPS technique that combines the benefits of partial splenectomy with those of a laparoscopic approach.

Methods

A chart review was conducted for three children with HS who underwent LPS, with approximately one-fourth of the spleen left on the basis of the short gastric arterial supply.

Results

The mean preoperative spleen size was 17.6 cm. The mean preoperative hemoglobin count was 100 g/l, and the postoperative hemoglobin count was 133 g/l. All three patients reported reduced malaise and increased energy levels. There was no recurrent anemia at the 1- to 2-year follow-up evaluation.

Conclusion

The LPS procedure is a safe and effective approach to HS that resolves anemia, potentially retains some splenic immunity, and confers the benefits of a minimal access technique.

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Acknowledgments

In 2004, Dr. Victoria Price was a recipient of the Baxter Bioscience Pediatric Hemostasis Fellowship at the Hospital for Sick Children, Toronto, Canada, during the period that this work was completed.

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Authors and Affiliations

  1. Division of Pediatric Surgery, Lucile Packard Children’s Hospital, Stanford University, Stanford, CA, USA

    S. Dutta

  2. Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children, 555 University Avenue, Suite 1526, Toronto, Canada, M5G 1X8

    V. E. Price & V. Blanchette

  3. Division of Pediatric General Surgery, Hospital for Sick Children, 555 University Avenue, Suite 1526, Toronto, Canada, M5G 1X8

    J. C. Langer

Authors
  1. S. Dutta
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  2. V. E. Price
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  3. V. Blanchette
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  4. J. C. Langer
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Corresponding author

Correspondence to J. C. Langer.

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Dutta, S., Price, V.E., Blanchette, V. et al. A laparoscopic approach to partial splenectomy for children with hereditary spherocytosis. Surg Endosc 20, 1719–1724 (2006). https://doi.org/10.1007/s00464-006-0131-3

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  • DOI: https://doi.org/10.1007/s00464-006-0131-3

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