title: Laparoscopic splenectomy for idiopathic thrombocytopenic purpura: outcome and long-term results.
abstract: The technical feasibility of laparoscopic splenectomy (LS) has been recently established. However, data regarding the efficacy of the procedure with long-term follow-up of patients with idiopathic thrombocytopenic purpura (ITP) are scarce. The objective of this study was to determine retrospectively the immediate efficacy and the long-term results of a standardized laparoscopic procedure applied to patients with ITP refractory to medical treatment. Laparoscopic splenectomy was performed in 35 patients for ITP between May 1993 and May 1998. The lateral approach was used in the last 27 patients. Data were recorded retrospectively on that group. Twenty-six patients (96%) underwent successful LS. Mean operative time for the laparoscopic procedure was 90 minutes. There were no postoperative deaths. Postoperative complications developed in three patients. Thrombocytopenia resolved after surgery in 93% of patients, but 7 patients (25%) experienced relapse during a mean 28-month follow-up. At present no patient needs medical therapy to maintain a normal platelet count. Laparoscopic splenectomy is feasible and safe in patients with ITP. Long-term results of LS for ITP are comparable to those achieved with open splenectomy.
authors.affiliation: Department of Surgery C, Hopital de Brabois, 54511 Vandoeuvre, France. laurentbresler@wanadoo.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Bresler
authors.forename: Agnes
authors.initials: A
authors.lastname: Guerci
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayav
authors.forename: Hugues
authors.initials: H
authors.lastname: Sebbag
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Tortuyaux
authors.forename: Pierre
authors.initials: P
authors.lastname: Lederlin
authors.forename: Patrick
authors.initials: P
authors.lastname: Boissel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects*; D013997:Time Factors