title: The feasibility of laparoscopic splenectomy for ITP patients without preoperative platelet transfusion.
abstract: OBJECTIVE
  The aim of this study was to investigate the feasibility and safety of laparoscopic splenectomy for idiopathic thrombocytopenic purpura patients without platelet transfusion before surgery.
  
  
  METHODS
  From 2004 to 2010, laparoscopic splenectomy was performed in 30 patients with ITP (idiopathic thrombocytopenic purpura, ITP) in our department and clinical information was recorded. Inclusion criteria is patient with a preoperative platelet count of <20x109/L. All of the 30 patients retrospectively reviewed were divided into 2 groups, according to whether they received platelet transfusion preoperatively or not. Perioperative data were analyzed.
  
  
  RESULTS
  The clinical efficacy of treatment was significant (obvious response rates of the two cohorts were 17/19 and 9/10). There was no significant difference in the surgical procedure or postoperative efficacy of laparoscopic splenectomy for ITP patients, regardless of whether there was preoperative platelet transfusion, including operating time, ratio of intraoperative blood transfusion, estimated blood loss, the rate of conversion, postoperative platelet counts, amount of postoperative drainage and postoperative hospital stay.
  
  
  CONCLUSIONS
  Laparoscopic splenectomy without platelet transfusion can be a feasible and safe procedure in patients with a platelet count lower than 20x109/L, with a normal prothrombin time and without any preoperative bleeding tendency or severe coagulopathy.
authors.affiliation: Department of Hepato-Pancreatic-Biliary Surgery, Sichuan University, Chengdu, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wu
authors.forename: Jin
authors.initials: J
authors.lastname: Zhou
authors.forename: Jianbo
authors.initials: J
authors.lastname: Li
authors.forename: Yankun
authors.initials: Y
authors.lastname: Zhu
authors.forename: Bing
authors.initials: B
authors.lastname: Peng
mesh_terms: D000293:Adolescent; D000328:Adult; D001777:Blood Coagulation; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002681:China; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D018579:Patient Selection; D010976:Platelet Count; D017713:Platelet Transfusion; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011517:Prothrombin Time; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000601:surgery*; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult