Akademik Veri Yönetim Sistemi
JOURNAL OF EVOLUTION OF MEDICAL AND DENTAL SCIENCES-JEMDS, cilt.10, sa.3, ss.118-122, 2021 (ESCI)
BACKGROUND Sickle cell anaemia (SCA) is one of the most common haemoglobinopathies in the world. In patients with SCA, cholecystectomy and splenectomy are the most common abdominal operations. In this study, we aimed to review the management of abdominal surgery in patients with SCA. METHODS This is a retrospective study. SCA patients who underwent abdominal surgery between June 2011 and June 2018 were included in our study. Demographic characteristics, preoperative and postoperative hematological parameters, details of the operations, peroperative management, postoperative complications and their management were examined. RESULTS We performed our study on operated SCA (n = 15) patients. 67 % (n = 10) of the patients were male. The age distribution of the patients was 32.8 +/- 13.8 (18 - 61) the patients' indications for operation were 73.3 % (n = 11) cholelithiasis 6.7 % (n = 1) spleen infarction 13.3 % (n = 2) hypersplenism and 6.7 % (n = 1) cholelithiasis + hypersplenism. Laparoscopic cholecystectomy (n = 9) laparoscopic splenectomy (n = 1) cholecystectomy (n = 1) cholecystectomy + splenectomy (n = 1) cholecystectomy + choledochoduodenostomy (n = 1) were the surgical operations performed on the patients. Preoperative blood counts showed haemoglobin (Hgb) (g / dL) 9.52 +/- 1.44 (6.1 - 11.1); hematocrit (Htc) % 28.6 +/- 5.42 (17.2 - 34.4) Haemoglobin S percentage (HbS) 55 +/- 24 (29 - 95). Since 7 patients had HbS over 40 % preop exchange transfusion was performed. Haemoglobin S percentage (HbS) after exchange transfusion was 23 +/- 7.2 (12 - 33) preoperative erythrocyte replacement was 1.13 +/- 1.3 (0 - 4). Postoperative blood counts showed; Haemoglobin (Hgb) (g / dL) 9.4 +/- 1.08 (7.1 - 11.4); hematocrit (htc) 28 % +/- 4.3 (21 - 37.6). The total duration of hospital stay was 11.2 +/- 4.05 (5 - 21) days; postoperative duration of stay was 4.6 +/- 2.16 (2 - 10) days. Postoperative surgical complications were 6.7 % (n = 1) wound infection and % 6.7 (n = 1) acute renal failure developed. Postoperative hematologic complications were 6.7 % (n = 1) developed vaso-occlusive crisis 6.7 % (n = 1) developed hemolytic crisis. No patients developed mortality. CONCLUSIONS Patients with SCA have a relatively high risk for postoperative complications. A multidisciplinary approach including hematologist, surgeon and anesthesiologist is required in the surgical management of SCA.