Safety and effectiveness of total splenic vessel ligations in paediatric patients with splenomegaly.

BACKGROUNDS: Splenomegaly may contribute to hypersplenism and can result in thrombocytopenia. Many approaches are used to treat splenomegaly; however, the current management of splenomegaly has intrinsic limitations or disadvantages. Now, we initiate a new approach, that of total splenic vessel (artery and vein) ligations (TSVLs) in paediatric patients with splenomegaly. The purpose of our study is to evaluate the results obtained with TVSLs procedure for paediatric patients.

PATIENTS AND METHODS: Seventeen paediatric patients with splenomegaly were screened for enrolment into this retrospective analysis.

PROCEDURE: We identified and dissociated the splenic vessel. Next, we ligated the splenic artery and we used clips to ligate the vein distally and proximally.

RESULT: The mean [standard deviation (SD)] splenic infarction rate of a total of 17 patients was 77.5 (5.1)% in 6 months after operation. After TSVL, the mean count of platelet (PLT) and white blood cell (WBC) increased significantly and reached a steady state in the third month. Both the PLT and WBC had a significance higher than pre-TSVL in a 1-year follow-up.

CONCLUSION: Based on the evidence, we make cautious conclusions that TSVLs are a safe and effective method in the treatment of paediatric patients with splenomegaly, achieving a satisfactory long-term haematological response and benefit.