PREOPERATIVE AND POSTOPERATIVE MANAGEMENT IN CHILDREN WITH SICKLE CELL ANEMIA UNDERGOING SURGERY: A SINGLE-CENTER EXPERIENCE

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OBJECTIVE: Surgical procedures are often required in sicklecell anemia (SCA). Patients with SCA are recognizedas having a relatively higher risk for postoperative complications.The aim of the present study was to evaluatethe preoperative and postoperative management of patientswith SCA undergoing surgery.MATERIALS AND METHODS: The medical records of allchildren with SCA who had surgery at our hospital wereretrospectively reviewed for the following: age, gender,preoperative investigations, and postoperative complications.RESULTS: From 2012 to 2014, 12 children with SCA hadsurgery at our hospital. The patients’ mean age was 12.1years (range, 6–17). Five patients were female. The surgicalprocedures were cholecystectomy (n=6), tonsillectomy/adenoidectomy (n=3), splenectomy (n=2) and excision ofovarian cyst (n=1). In a patient who had undergone splenectomy,concomitant cholecystectomy were also performed.Patients received simple packed red blood celltransfusion (n=1) or total exchange transfusion (n=10)before the surgery. One patient was not transfused whichwas already enrolled in a chronic transfusion program. Allpatients received intravenous hydration the night beforethe surgery and postoperatively. The mean postoperativehospital stay was 5.3 days (range, 3-10). There were novaso-occlusive crises or deaths.CONCLUSIONS: Children with sickle cell disease presentingfor elective surgery should be given a transfusion fora hemoglobin S ratio less than 40% in an attempt to reducepostoperative complications. With good preoperativeand postoperative management, surgery is both safe andeffective for children with SCA.

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Sickle cell anemia , surgery , complication

Kocatepe Medical Journal

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Kocatepe Medical Journal