Splenectomy and major sickle cell syndromes in Ouagadougou

Abstract

Backround : Splenectomy in major sickle cell syndromes have specific indications. The main one is hypersplenism.
The aim of our research was to study and to compare the clinical and hematological parameters pre and
postoperatively.
Material and Method : This was a retrospective cohort study with an analytical aim of splenectomy performed in
patients with major sickle cell syndromes from 2010 to 2019 at two hospitals in the visceral surgery departments of
the Yalgado Ouédraogo Hospital and the Saint Camille Hospital in Ouagadougou.

Results: In 10 years, 31 cases were collected. The mean age of the patients was 27.6±2 years. A history of at least
three vaso-occlusive crises per year was noted in all cases. Physical examination revealed painful splenomegaly in
19 cases. Haemoglobin phenotypes were: 16 cases (SC), 10 cases (SS), 5 cases (Sβ+). The average blood transfusion
was 6±2/person/year. Splenectomy was indicated for repeated attacks of hypersplenism in 18 cases. Twenty-nine
patients underwent total splenectomy. In 40.8% of cases, splenectomy was associated with cholecystectomy. In one
month postoperatively, the haematological parameters showed clear improvement with an increase in the
haemoglobin level of 3.7 points (p = 0.001). Morbidity was 3.7% and zero mortality.
Conclusion : Splenectomy decreases the postoperative transfusion needs in the short and medium term.