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This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Haberkern, C. M. Articles by the Preoperative Transfusion in Sickle Cell Disease Study Group, Search for Related Content PubMed PubMed Citation Articles by Haberkern, C. M. Articles by the Preoperative Transfusion in Sickle Cell Disease Study Group, Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Cholecystectomy in sickle cell anemia patients: perioperative outcome of 364 cases from the National Preoperative Transfusion Study. Preoperative Transfusion in Sickle Cell Disease Study Group CM Haberkern, LD Neumayr, EP Orringer, AN Earles, SM Robertson, D Black, MR Abboud, M Koshy, O Idowu and EP Vichinsky Department of Anesthesiology, University of Washington, Seattle, USA. Cholecystectomy is the most common surgical procedure performed in sickle cell anemia (SCA) patients. We investigated the effects of transfusion and surgical method on perioperative outcome. A total of 364 patients underwent cholecystectomy: group 1 (randomized to aggressive transfusion) 110 patients; group 2 (randomized to conservative transfusion) 120 patients; group 3 (nonrandomized nontransfusion) 37 patients; and group 4 (nonrandomized transfusion) 97 patients. Patients were similar except group 3 patients were more likely to be female, over 20 years old, smokers, and more healthy by American Society of Anesthesiologists (ASA) physical status score. Total complication rate was 39%: sickle cell events 19%; intraoperative or recovery room events 11%; transfusion complications 10%; postoperative surgical events 4%; and death 1%. Group 3 patients had the highest incidence of sickle cell events (32%). Open cholecystectomies were performed in 58% and laparoscopic in 42%. Laparoscopic patients were younger and more healthy by ASA score. Laparoscopic patients had longer anesthesia time (3.2 v 2.9 hours), but shorter hospitalization time (6.4 days v 9.8). Complications were similar between these two groups. We conclude that SCA patients undergoing cholecystectomy have a high perioperative morbidity, and the incidence of sickle cell events may be higher in patients not preoperatively transfused. We recommend a conservative preoperative transfusion regimen, and we encourage the use of the laparoscopic technique for SCA patients undergoing elective cholecystectomy. Volume 89, Issue 5, pp. 1533-1542, 03/01/1997 Copyright © 1997 by The American Society of Hematology CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: P. G. Firth, M. T. Gladwin, G. J. Kato, and E. Vichinsky Pulmonary Complications of Sickle Cell Disease N. Engl. J. Med., March 5, 2009; 360(10): 1044 - 1045. [Full Text] [PDF] P. G. Firth Anaesthesia for peculiar cells--a century of sickle cell disease Br. J. Anaesth., September 1, 2005; 95(3): 287 - 299. [Abstract] [Full Text] [PDF] R. Lottenberg and K. L. Hassell An Evidence-Based Approach to the Treatment of Adults with Sickle Cell Disease Hematology, January 1, 2005; 2005(1): 58 - 65. [Abstract] [Full Text] [PDF]

	Copyright © 1997 by American Society of Hematology         Online ISSN: 1528-0020