title: Laparoscopic splenectomy with interferon therapy in 100 hepatitis-C-virus-cirrhotic patients with hypersplenism and thrombocytopenia.
abstract: OBJECTIVE
  We intended to determine whether laparoscopic splenectomy (Lap-Sp) contributes to treatment with interferon therapy in hepatitis C virus (HCV)-cirrhotic patients with thrombocytopenia caused by hypersplenism.
  
  
  METHODS
  From December 2004 to August 2008, 100 cirrhotic patients (54 men and 46 women) underwent Lap-Sp for a clinical application of interferon therapy. All the patients were Child-Pugh class A or B with thrombocytopenia (average platelet count, 56 × 10(3) /mm(3)). The HCV genotype was type 1 in 80 patients and type 2 in 20 patients.
  
  
  RESULTS
  Pure laparoscopic or hand-assisted laparoscopy was performed in 78 and 22 patients, respectively, without mortality. Conversion to open surgery was not required in any of the patients. The platelet counts improved (mean platelet count 172 × 10(3) /mm(3) 1 month after surgery) and interferon (IFN) therapy was started in 97 patients. In this study period, 36 patients obtained a sustained virologic response. Eight patients discontinued IFN therapy because of depression, neutropenia or other reasons.
  
  
  CONCLUSIONS
  Lap-Sp permits most patients with HCV cirrhosis and hypersplenism to receive sufficient IFN therapy. Therefore, Lap-Sp can become a strong supportive surgery for cirrhotic patients who require antiviral therapy.
authors.affiliation: Department of Surgery and Science, Kyushu University, Fukuoka, Japan. a_tom411@yahoo.co.jp
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Akahoshi
authors.forename: Morimasa
authors.initials: M
authors.lastname: Tomikawa
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawanaka
authors.forename: Norihiro
authors.initials: N
authors.lastname: Furusyo
authors.forename: Nao
authors.initials: N
authors.lastname: Kinjo
authors.forename: Norifumi
authors.initials: N
authors.lastname: Tsutsumi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nagao
authors.forename: Jun
authors.initials: J
authors.lastname: Hayashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Hashizume
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D058733:Hand-Assisted Laparoscopy; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D006971:Hypersplenism / Q000628:therapy* / Q000821:virology; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D007564:Japan; D010535:Laparoscopy / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D013921:Thrombocytopenia / Q000628:therapy* / Q000821:virology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b