Acute chest syndrome after abdominal surgery in children with sickle cell disease: Is a laparoscopic approach better?

Background/Purpose: Acute chest syndrome (ACS) is the leading cause of hospitalization and death among patients with sickle cell disease (SCD). Surgery is a risk factor for the development of ACS. It has been suggested that laparoscopic surgery could diminish the risk of sickle-related complications...

Full description

Saved in:
Bibliographic Details
Published in:Journal of pediatric surgery 2001-05, Vol.36 (5), p.718-721
Main Authors: Wales, P.W., Carver, E., Crawford, M.W., Kim, P.C.W.
Format: Article
Language:English
Subjects:
Abdomen
acute chest crisis
Acute Disease
Adolescent
Anemia, Sickle Cell - complications
Biological and medical sciences
Blood Transfusion
Child
Child, Preschool
Cholecystectomy - adverse effects
Female
Humans
laparoscopy
Laparoscopy - adverse effects
Laparotomy - adverse effects
Length of Stay - statistics & numerical data
Lung Diseases - diagnosis
Lung Diseases - etiology
Lung Diseases - prevention & control
Lung Diseases - therapy
Male
Medical sciences
Morbidity
Patient Selection
Pneumology
Respiratory system : syndromes and miscellaneous diseases
Retrospective Studies
Risk Factors
Sickle cell disease
Splenectomy - adverse effects
surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Syndrome
Time Factors
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background/Purpose: Acute chest syndrome (ACS) is the leading cause of hospitalization and death among patients with sickle cell disease (SCD). Surgery is a risk factor for the development of ACS. It has been suggested that laparoscopic surgery could diminish the risk of sickle-related complications; therefore, more procedures may be encouraged in asymptomatic patients. The goal of the authors was to determine the incidence of postoperative ACS and assess for predisposing factors in all sickle cell patients undergoing abdominal surgery. Methods: A retrospective analysis of all sickle cell patients receiving abdominal surgery (open and laparoscopic) between 1994 and 1998 was conducted. Data pertaining to demographics, perioperative clinical status, postoperative care, and outcome were collected and analyzed using Student's t test or χ2 where appropriate. Results: Fifty-four children underwent 62 procedures (35 abdominal and 27 extracavitary). All abdominal cases were either cholecystectomy or splenectomy (22 laparoscopic and 13 open). ACS occurred in 7 of 62 (11.3%) overall, and all were in abdominal cases 7 of 35 (20%). ACS occurred in 5 of 22 (22.7%) laparoscopic cases and 2 of 13 (15.4%) open cases. Operating time was significantly longer in the laparoscopic group compared with open cases (P
ISSN:0022-3468
1531-5037
DOI:10.1053/jpsu.2001.22944