Results of splenectomy for idiopathic thrombocytopenic purpura. Review of 72 cases.
Seventy-two patients underwent splenectomy for idiopathic thrombocytopenic purpura between 1979 and 1990. Mean age at splenectomy was 36.4 years (range 11-73). Indications for splenectomy were corticodependence in 21 cases and resistance to steroids in 44 cases. Thirty-five patients had platelet kinetic studies by 51Cr alloplatelets; 22 of them had splenic sequestration. Hematologic results were evaluated on discharge, at 3 months and in the long term (median follow-up 5.4 years). We had no mortality, morbidity was seen in 7% of the cases. None of the patients suffered from secondary infectious complications. 89% had good results on discharge (> 120 x 10(9)/l), 72.6% at 3 months and 90% on long-term follow-up. Factors associated with good response to splenectomy included a high postoperative platelet count (more than 120 x 10(9)/l on discharge), younger age at the time of surgery, preoperative corticodependence and predominantly splenic sequestration.
Naouri
A
A
Department of General and Digestive Surgery, Edouard Herriot Hospital, Lyon, France.
Feghali
B
B
Chabal
J
J
Boulez
J
J
Dechavanne
M
M
Viala
J J
JJ
Tissot
E
E
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011183:Postoperative Complications; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000401:mortality / Q000601:surgery*; D012074:Remission Induction; D013156:Splenectomy / Q000009:adverse effects / Q000401:mortality
D000305:Adrenal Cortex Hormones