{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:38:55Z","timestamp":1792625935623,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T00:00:00Z","timestamp":1492473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hereditary spherocytosis (HS) is a heterogeneous hemolytic anemia treated with splenectomy in patients suffering from severe or moderate disease. Total splenectomy, however, renders patients vulnerable to overwhelming postsplenectomy infection despite preventive measures. Although subtotal splenectomy has been advocated as an alternative to total splenectomy, long\u2010term follow\u2010up data are scarce. We investigated how often hematologic recurrences requiring secondary total splenectomy occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>With a follow\u2010up of at least 5 years, we analyzed the data of 12 patients, aged 11 years maximum (median 6.5 years), who had undergone intended subtotal splenectomy, and 9 patients (median age 11.9 years), who had undergone total splenectomy. We compared their hematologic results and searched for factors associated with secondary spleen surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hemolysis was reduced after subtotal splenectomy and absent after total splenectomy. Subtotal splenectomy was not successful in three children because no functional splenic remnant remained after 6 months (one conversion at surgery; one necrosis of splenic remnant; one early secondary splenectomy). Four children required secondary splenectomy after a median of 5 years for hematologic recurrence. In the remaining five patients, a functional splenic remnant was present for at least 5.5 years. The median time to secondary total splenectomy after intended subtotal splenectomy was 5.2 years. In all patients requiring secondary total splenectomy, increased reticulocyte levels within 2 years indicated hematologic recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Subtotal splenectomy can be an alternative for total splenectomy in young patients with HS. It allows for hematologic improvement and may preserve splenic immune function for as many as 5 years.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.26592","type":"journal-article","created":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T07:56:38Z","timestamp":1492502198000},"source":"Crossref","is-referenced-by-count":19,"title":["A long\u2010term follow\u2010up study of subtotal splenectomy in children with hereditary spherocytosis"],"prefix":"10.1002","volume":"64","author":[{"given":"C. W. K.","family":"Rosman","sequence":"first","affiliation":[{"name":"Division of Pediatric Oncology and Hematology Department of Pediatrics University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. M. A.","family":"Broens","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery Department of Surgery University of Groningen University Medical Center Groningen  Groningen The Netherlands"},{"name":"Anorectal Physiology Laboratory Department of Surgery University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Trzpis","sequence":"additional","affiliation":[{"name":"Anorectal Physiology Laboratory Department of Surgery University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Y. J.","family":"Tamminga","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology and Hematology Department of Pediatrics University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.08921.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07694.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2010.03849.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-04-210112"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2012.09146.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-8-200910200-00008"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268816002405"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V81.8.2014.2014"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.2.399"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.171.6.9843315"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05956.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-11-679357"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.SLA.0000048453.61168.8F"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.09.090"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.01.037"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26106"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12649"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2002.35412"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000150070.69769.39"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.26592","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.26592","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T22:10:33Z","timestamp":1696025433000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.26592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,18]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1002\/pbc.26592"],"URL":"https:\/\/doi.org\/10.1002\/pbc.26592","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,18]]},"article-number":"e26592"}}