Splenectomy for idiopathic thrombocytopenic purpura: comparison of laparoscopic and conventional surgery.
BACKGROUND
This study aimed to compare the safety, efficacy, and clinical benefits of laparoscopic splenectomy (LS) to open splenectomy (OS) in patients with idiopathic thrombocytopenic purpura (ITP).


METHODS
The results from 14 consecutive patients who underwent LS for ITP were reviewed and compared with the results from patients who underwent OS for the same disease. Demographics, concomitant disease on admission, and platelet counts were evaluated, as were details of the surgical procedure, postoperative physiologic status, and hospital stay.


RESULTS
Mean operative time was 88.3 min for OS and 146.4 min in LS group (p < 0.05). The conversion rate to open splenectomy was 7.1. Therapeutic response to splenectomy was 92.8% in the LS group and 86.6% in the OS group. Bowel canalization, return to liquid diet, and length of hospital stay were all significantly delayed in the OS group as compared with those who underwent LS (p = 0.01, p = 0.02, p = 0.005, respectively). In the OS group the morbidity rate was 13.3%, whereas in the LS group it was 7.1%.


CONCLUSIONS
Laparoscopic splenectomy represents a valid alternative to conventional splenectomy in the treatment of ITP.
Marassi
A
A
IRCCS San Raffaele, Department of Surgery, University of Milan, Italy.
Vignali
A
A
Zuliani
W
W
Biguzzi
E
E
Bergamo
C
C
Gianotti
L
L
Di Carlo
V
V
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016011:Normal Distribution; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D013154:Spleen; D013156:Splenectomy / Q000379:methods*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome