Splenectomy in Sickle Cell Haemoglobinopathies from a Tertiary Hospital of Southern Odisha: A Retrospective Study

Abstract

Introduction: Sickle Cell Disease (SCD) is a common haemoglobinopathy, where spleen is considered to be the first organ to be involved. Although it initially undergoes enlargement, but most often there occurs autosplenectomy. But in some cases, there is persistence of splenomegaly which may be associated with various complications. In these situations, splenectomy is considered as a good option to mitigate all these morbidities. Aim: To analyse the effect of splenectomy on haematological parameters and complications in patients of SCD in postoperative period. Materials and Methods: This was a retrospective study conducted at SLN Medical College and Hospital, Koraput, Odisha, India, from April 2019 to March 2021. Total 42 patients of SCD underwent splenectomy. The haematological parameters {Haemoglobin (Hb), Total Leukocyte Count (TLC) and Total Platelet Count (TPC)} and blood transfusion needs were compared in preoperative and postoperative periods and analysed statistically with Student’s t-test. Results: Primary indication of splenectomy was hypersplenism 31 (73.8%) followed by splenic sequestration crisis in 8 patients (19.05%) and splenic abscess in 3 patients (7.1%). Postsplenectomy haemoglobin improvement was around 5.17 gm% (p-value<0.001). Postoperative complication was also minimal, seen in only eight patients, it was mostly due to surgical site infection (n=6) and fever (n=8). Preoperative blood transfusion rate was 9.07±1.92. Blood transfusion requirement rates were also drastically reduced to 0.5±0.707 postsplenectomy in these patients (p-value<0.001). Conclusion: Following splenectomy, the need of blood transfusion was grossly reduced and also, the incidence of its complication was reduced.

Keywords

• hypersplenism
• sickle cell diseases
• splenomegaly