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

Laparoscopic surgery in children

“…Wales et al 23 reported a retrospective study that examined the incidence of the acute chest syndrome following surgery in children with sickle cell disease. This is a potentially serious complication of sickle cell disease characterised by erythrocyte sickling within the pulmonary vasculature.…”

Risk factors for acute chest syndrome in children with sickle cell disease undergoing abdominal surgery

“…2,3 Interestingly, ACS occurs significantly more frequently after abdominal surgery when compared with other procedures 4,5 and the reported incidence of ACS after abdominal surgery in children is 15% to 20%. [5][6][7] The hemolytic anemia in children with SCD and the associated elevated bilirubin levels many times lead to symptomatic gallstones necessitating cholecystectomy. Splenic sequestration of RBCs and hypersplenism frequently warrants splenectomy.…”

Preoperative screening for sickle cell disease in children: clinical implications

“…15 Reviewing our experience over 15 years, perioperative sickle-related complications, of which the most frequent was acute chest syndrome, occurred only in patients who had a longstanding history of sickle cell disease and who were undergoing surgery for the complications of the disease, such as cholecystectomy or splenectomy. 17,18 In those retrospective studies, we encountered no sickle-related complications when the diagnosis of sickle cell disease was unknown at the time of the preoperative interview, or when it was made as a result of routine preoperative screening. These observations prompted us to question the clinical value of subjecting every child of African ancestry to preoperative venepuncture for the sole purpose of screening for sickle cell disease.…”