Laparoscopic splenectomy for hematologic diseases.
BACKGROUND
Laparoscopic splenectomy has been demonstrated to be technically feasible and safe for the treatment of hematologic diseases.


METHODS
The study comprised 64 consecutive patients with chronic immune thrombocytopenia purpura (ITP) who were admitted to our hospital from 1992 to 2000 and underwent laparoscopic splenectomy. Forty-one consecutive patients with ITP who underwent open splenectomy performed at the same hospital by the same surgical team between 1986 and 2000 were selected as the control group.


RESULTS
We performed laparoscopic splenectomies for ITP, hereditary spherocytosis (HS), malignant lymphoma, autoimmune hemolytic anemia, and cryoglobulinemia. Laparoscopic surgery as compared with open surgery in ITP revealed a significantly lower pain medication requirement, an earlier resumption of oral intake, and a shorter hospital stay, but a longer operative time. During the present study (range: 3.8-80 months), the cumulative rate of nonrecurrence was 67.9% at 5 years after surgery, which was similar to the rate for the previous open splenectomy.


CONCLUSIONS
Laparoscopic splenectomy is considered to be a suitable alternative therapeutic modality in the treatment of hematologic diseases.
Tanoue
Kazuo
K
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Okita
Keishi
K
Akahoshi
Tomohiko
T
Konishi
Kouzou
K
Gotoh
Norikazu
N
Tsutsumi
Norifumi
N
Tomikawa
Morimasa
M
Hashizume
Makoto
M
D000743:Anemia, Hemolytic / Q000601:surgery; D003449:Cryoglobulinemia / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008223:Lymphoma / Q000601:surgery; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013103:Spherocytosis, Hereditary / Q000601:surgery; D013156:Splenectomy / Q000379:methods*