نتايج حاصل از عمل جراحي طحال برداري در بيماران بتا تالاسمي ماژور

OUTCOMES OF SPLENECTOMY IN THALASSEMIC PATIENTS

Thalassemic patients need recurrent transfusion due to the RBC hemolysis resulted from hereditary defect in beta globin chain synthesis. This might lead to transfusion complications such as hemochromotosis, splenomegaly and othersʹ associated complications. Most cases might need splenectomy for avoiding recurrent transfusion and splenomagaly complications. In this study, we tried to evaluate the outcomes of splenectomy in 45 patients. This descriptive and retrospective study was done on 45 thalassemic patients who under went splenectomy during the last 10 years. Twenty eight patients (62.2%) suffered from major thalassemia and the remaining 17 (37.8%) had thalassemia intermediate. Most patients were over 15 years old. 27 (60%) patients had huge splenomegaly up to or over umbilicus, 5 (14.5%) simultaneous gallbladder stone removal and 11 (24.5%) LUQ pain with early satiety. Forty three of the patients (95.5%) received 20 CC packed blood cell for each five kg of body weight. After splenectomy 23 (57.5%) of the patients did not need any blood transfusion from a month to a year; 6 (15%) did not require transfusion after a year. Overall, the amount of transfusion decreased in all patients. All of the patients felt healthier after splenectomy. Operative complications occurred in 3 (6.66%) of patient, despite pre-opretion vaccination with Pneumovax polyvalent various infections occurred in 9 (20%) on long term. Therefore, the finding of this study suggest that splenectomy is recommended only in thalacemic patients in whom there is a need for high level of blood transfusion and in those who suffer from symptomatic splenomegaly.