Medknow Publications on behalf of the Indian Association of Pediatric Surgeons
Abstract
Background : In this study, we show the advantages of partial
splenectomy (PS) over total splenectomy (TS) regarding the chances of
overwhelming postsplenectomy sepsis (OPSI). Materials and Methods:
From February 1991 to December 1999, 143 cases of β-thalassemia
underwent PS. 1/3, 1/4 of the splenic tissue was preserved. One hundred
and ten cases were followed for an average of 5 years. None of the
patients received vaccination or prophylactic antibiotics. Pre- and
postoperative hematological profiles, IgM levels, recurrence of
hypersplenism and septic episodes were compared among the data of 60
cases TS; all these cases have been operated in the same hospital.
Results: Hematological profile significantly increased and transfusion
requirement approximately reduced to three-fold. After 3 years, 22.7%
in PS and 13.3% in TS groups required the same amount of preoperative
transfusion. After 5 years, these percentages were 27.3 and 18.3%,
respectively. Two patients in PS and six in TS group developed signs of
sepsis. Conclusion : Vaccination or prophylactic antibiotics are not
necessary after PS. The risk of sepsis in PS without antibiotics is
less than that in TS with antibiotics, and resplenectomy after PS is
not associated with serious complications
