An 18-year review of open and laparoscopic splenectomy for idiopathic thrombocytopenic purpura.
BACKGROUND
Laparoscopic splenectomy has become the preferred surgical procedure for the management of idiopathic thrombocytopenic purpura (ITP). However, there studies have directly compared the incidence of recurrent ITP secondary to missed accessory spleens in open versus laparoscopic splenectomy.


METHODS
Open and laparoscopic splenectomies performed for ITP at 4 sites over 18 years were analyzed. The incidence of recurrent disease secondary to missed accessory spleens was compared between the open and laparoscopic splenectomy groups.


RESULTS
A total of 105 splenectomies (54 open/51 laparoscopic) were performed. Accessory spleens were identified in 6 laparoscopic and 6 open cases (P = .57). Recurrent disease occurred in 27.6% of open and 14.6% of laparoscopic cases (P = .222). There were no cases of recurrent ITP secondary to a missed accessory spleen in either group.


CONCLUSIONS
The incidence of missed accessory spleens causing recurrent disease is similar when splenectomy is performed either open or laparoscopically.
Sampath
Sharadh
S
Centre of Excellence for Surgical Education and Innovation, 3602-910 W. 10th Avenue, Vancouver, British Columbia, Canada V5Z 4E2.
Meneghetti
Adam T
AT
MacFarlane
John K
JK
Nguyen
Nam H
NH
Benny
W Barrett
WB
Panton
Ormond N M
ON
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D013997:Time Factors