[Splenectomy for thrombocytopenic purpura. Retrospective analysis of the postoperative course].
BACKGROUND
Idiopathic thrombocytopenic purpura (ITP) comprises approximately 8% of all haemorrhagic diseases. Typical findings are a very low platelet count which manifests as petechial bleeding. Therapy consists of medication and removal of the spleen if conservative therapy fails.


METHODS
Between 1988 and 1999, 47 patients with ITP were splenectomized in our surgical department. We examine the postoperative development of platelet counts and long-term results in 33 of these patients.


RESULTS
After splenectomy, more then 75% of our patients had normal platelet counts. In long-term examination, 58% remained in stable condition with normal platelet counts. Retrospectively we tried to identify preoperative clinical features that could predict the long-term outcome of splenectomy in ITP but were unable to find reliable factors.


CONCLUSIONS
Idiopathic thrombocytopenic purpura can be treated by surgical means but should be considered only when conservative treatment has failed. The long-term outcome of splenectomy is not predictable. Reliable predictive factors have to be identified through further research.
Beseoglu
K
K
Neurochirurgie, Universitätsklinikum Düsseldorf. Beseoglu@med.uni-duesseldorf.de
Germing
U
U
Gross-Weege
W
W
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D013156:Splenectomy; D016896:Treatment Outcome