Laparoscopic splenectomy for immune thrombocytopenic purpura in patients with severe refractory thrombocytopenia.
Laparoscopic splenectomy (LS) for immune thrombocytopenic purpura has a success rate of 70-90%. This invasive procedure is sometimes required for patients with refractory thrombocytopenia. However, no data on their outcome are available. If the hematologic response is inadequate, its value vis-à-vis the risk associated with major surgery is open to question. Twelve of 110 patients who underwent LS in our institution had a platelet count lower than 20 x 10(9)/l (mean 6.6 x 10(9)/l). Nine patients (75%) had a good-to-excellent hematologic response. The complication rate was 33%. LS in patients with very low platelet counts is feasible and yields a response rate similar to the average of patients with immune thrombocytopenic purpura. However, it bears a higher perioperative morbidity compared with LS in patients with higher counts.
Keidar
Andrei
A
Department of Surgery 'B', Tel Aviv Sourasky Medical Center, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sagi
Boaz
B
Szold
Amir
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007239:Infections / Q000209:etiology; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000150:complications / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*; D016896:Treatment Outcome