Hereditary hemolytic anemias are disorders with a variety of causes, including red cell membrane defects, red blood cell enzyme disorders, congenital dyserythropoietic anemias, thalassemia syndromes, and hemoglobinopathies. Splenectomy is one possible therapeutic approach in management and haematological conditions were cited as one of the leading indications. However, the short-term and long-term advantages and challenges that splenectomy offers in the scenario of these anemias is not strongly evidence-based, except for that in hereditary spherocytosis as of now. Aims of our study are to establish the indication for elective splenectomy in adults with hemolytic anemias and to evaluate the effectiveness of splenectomy in treating the indication. We also review our experience in the management of such patients and compare with other studies. A case series of 27 patients over a period of two years from June 2016 to June 2018 referred to our department were included. According to our study, hypersplenism was the most common indication for splenectomy in adult patients with hemolytic anemias. We have followed open approach and performed simultaneous splenectomy and cholecystectomy for all patients with concomitant cholelithiasis. Our study achieved 100% improvement in the indication with minimal comorbidity due to strict adherence to protocols even in these patients. However, more detailed studies in this subset of patients is needed for establishment of guidelines and optimal outcomes.

Keywords: Spleen, hemolytic anemias, adult, hypersplenism, elective, splenectomy.

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Dr Chinthagada Jaya Raj, MS.MCh.

Professor and HOD of Surgery, Department of General Surgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India Pin code – 530002