Nusrat Anis, Anis Subhan.
Splenectomy in Thalassaemia : a personal experience.
Pak J Surg Jan ;22(4):205-7.

Objective: To assess the efficacy and benefits of splenectomy in Thalassaemic patients with hypersplenism. Design & Duration: Prospective study from June 2003 to April 2006. Setting: Patients registered and referred from the Thalassaemia Control Centre of Husaini Blood Bank, underwent splenectomy at Hashmani?s Hospital and Hamdard University Hospital, Karachi. Patients: 23 patients of thalassaemia with hypersplenism underwent splenectomy, but only 20 were included as three could not be followed-up. Methodology: Patients of thalassaemia are registered and treated at the Thalassaemia Control Centre of the Hussaini Blood Bank.Complete data of the patients is kept at the centre. Those with hypersplenism are referred for splenectomy. These cases were followed-up regularly and development of any complications noted. Results: Out of the 20 patients, 13 were males and seven were females, with a mean age of 13.9 years (range 9-19 years). Nineteen suffered from thalassaemia major and one from thalassaemia intermedia. Two (10%) cases deve- loped haematomas at the incision site while one (5%) had to be re-explored for venous bleeding on the fourth day. None of the post-splenectomized patients developed any serious infection in the follow-up ranging from four months to three years. There is a significant reduction in the number of transfusions required post-operatively. One patient died in the first 24 hours due to non-surgical causes resulting in a mortality rate of 5%. Conclusion: Splenectomy can be carried out relatively safely in patients suffering from thalassaemia with proper pre-operative cardiac and anaesthetic assessment. After splenectomy there was a significant reduction in the number of transfusions required. Those thalassaemic patients who are suffering from hypersplenism can avail the benefits of splenectomy without undue risk.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com