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Total versus partial splenectomy in pediatric hereditary spherocytosis: A systematic review and meta‐analysis

To compare the clinical effectiveness of total splenectomy (TS) or partial splenectomy (PS) in pediatric hereditary spherocytosis, a systematic review and meta‐analysis was performed (PROSPERO registration CRD42015030056). There were 14 observational studies comparing pre‐ and postoperative hematologic parameters. Secondary outcomes include in‐hospital infections, surgical complications, symptomatic recurrence, and biliary disease. TS is more effective than PS to increase hemoglobin (3.6 g/dl vs. 2.2 g/dl) and reduce reticulocytes (12.5% vs. 6.5%) after 1 year; outcomes following PS are stable for at least 6 years. There were no cases of overwhelming postsplenectomy sepsis. A population‐based patient registry is needed for long‐term follow‐up.