Splenectomy versus conservative management for acute sequestration crises in people with sickle cell disease
Autor: | Tracey Remmington, Shirley Owusu-Ofori |
---|---|
Rok vydání: | 2017 |
Předmět: |
Medicine General & Introductory Medical Sciences
medicine.medical_specialty Blood transfusion Anemia medicine.medical_treatment Splenectomy MEDLINE Anemia Sickle Cell Disease law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Blood Transfusion Pharmacology (medical) 030212 general & internal medicine Intensive care medicine Splenic Diseases business.industry medicine.disease Surgery Clinical trial Acute Disease Splenic disease business 030217 neurology & neurosurgery |
Zdroj: | The Cochrane Library |
ISSN: | 1465-1858 |
Popis: | Background Acute splenic sequestration crises are a complication of sickle cell disease, with high mortality rates and frequent recurrence in survivors of first attacks. Splenectomy and blood transfusion, with their consequences, are the mainstay of long-term management used in different parts of the world. This is a 2017 update of a Cochrane Review first published in 2002, and previously updated, most recently in 2015. Objectives To assess whether splenectomy (total or partial), to prevent acute splenic sequestration crises in people with sickle cell disease, improved survival and decreased morbidity in people with sickle cell disease, as compared with regular blood transfusions. Search methods We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, which comprises of references identified from comprehensive electronic database searches and handsearching relevant journals and abstract books of conference proceedings. We also searched clinical trial registries. Additional trials were sought from the reference lists of the trials and reviews identified by the search strategy. Date of the most recent search: 14 August 2017. Selection criteria All randomized or quasi-randomized controlled trials comparing splenectomy (total or partial) to prevent recurrence of acute splenic sequestration crises with no treatment or blood transfusions in people with sickle cell disease. Data collection and analysis No trials of splenectomy for acute splenic sequestration were found. Main results No trials of splenectomy for acute splenic sequestration were found. Authors' conclusions Splenectomy, if full, will prevent further sequestration and if partial, may reduce the recurrence of acute splenic sequestration crises. However, there is a lack of evidence from trials showing that splenectomy improves survival and decreases morbidity in people with sickle cell disease. There is a need for a well-designed, adequately-powered, randomized controlled trial to assess the benefits and risks of splenectomy compared to transfusion programmes, as a means of improving survival and decreasing mortality from acute splenic sequestration in people with sickle cell disease. There are no trials included in the review and we have not identified any relevant trials up to August 2017. We will continue to run searches to identify any potentially relevant trials; however, we do not plan to update other sections of the review until new trials are published. |
Databáze: | OpenAIRE |
Externí odkaz: |