Splenectomy for hematologic disease in children

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Splenectomy for the treatment of hematologic disorders in adult patients is frequently performed with relative assurance of success, depending on the hematologic disease.1–3 In children with hematologic disease, however, splenectomy is often undertaken with much more concern. There are several reasons why removal of the spleen in a child may be associated with greater morbidity. (1) The risk of any major surgical operation in a child may be greater than the risk of the same procedure in an adult. (2) In the young child or infant, loss of the spleen may weaken the immunologic defense of the body to infection. (3) The long-term effects of splenectomy on host resistance and bodily defense to other noninfectious processes, such as malignancies or collagen disorders, are not known. (4) Less is known about the response of hematologic disorders to splenectomy in children, as compared to adults. Fewer follow-up studies have been conducted on the results of splenectomy for hematologic disease in children than in adults.

Clinical material

This report concerns the results of splenectomy for hematologic disorders in 51 children seen at the Cleveland Clinic from 1956 through 1970. Follow-up reports have been obtained on 49 of the 51 children, with a mean follow-up period of 8 years and 10 months (106 months).

thrombocytopenic purpura included a history of epistaxis or other prolonged

During this 14-year period, 690 splenectomies were performed for hematologic disorders in both adults and children. Splenectomy for hematologic disease in children thus accounted for 7.4% of our total . . .



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