Results of laparoscopic splenectomy for immune thrombocytopenic purpura.
BACKGROUND
Laparoscopic splenectomy has been demonstrated to be technically feasible and safe for the treatment of immune thrombocytopenic purpura (ITP), hereditary spherocytosis, and Hodgkin's disease.


METHODS
The study comprised 76 consecutive patients with chronic ITP who were admitted to our hospital from 1968 to 1997 and underwent splenectomy; 35 patients underwent a laparoscopic splenectomy, and 41 had open surgery.


RESULTS
Laparoscopic splenectomy involved minimal incision, and a significantly lower frequency of analgesia was required for postoperative abdominal pain (1.4 versus 3.3); postoperative hospital stay was shorter (9.6 versus 20.1 days, P <0.05). Operative time was significantly longer for the laparoscopic surgery (204.5 versus 99.8 minutes, P <0.01), but blood loss was less (154.4 versus 511.7 g, P <0.01). During the present study (range 3.8 to 80 months), accumulative nonrecurrence rate was 67.9% in 5 years after surgery, which is similar to that of the previous open splenectomy.


CONCLUSIONS
Laparoscopic splenectomy can become an alternative therapeutic modality in the treatment of ITP.
Tanoue
K
K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hashizume
M
M
Morita
M
M
Migoh
S
S
Tsugawa
K
K
Yagi
S
S
Ohta
M
M
Sugimachi
K
K
D000328:Adult; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D010976:Platelet Count; D011183:Postoperative Complications; D011696:Purpura, Thrombocytopenic / Q000097:blood / Q000276:immunology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012449:Safety; D013156:Splenectomy / Q000379:methods*; D016896:Treatment Outcome