title: Laparoscopic splenectomy for primary immune thrombocytopenia: clinical outcome and prognostic factors.
abstract: BACKGROUND
  Laparoscopic splenectomy (LS) is considered the standard treatment for patients with refractory primary immune thrombocytopenia (ITP).
  
  
  METHODS
  All patients with ITP who underwent LS during the last 17 years and who had a minimum follow-up of 1 year were included. Several perioperative variables such as age, platelet count, and duration of preoperative therapy were recorded and analyzed, looking for potential predictive variables of clinical response.
  
  
  RESULTS
  In total, 150 patients were included: 108 (72%) women and 42 (28%) men, with a mean age of 37.3±15.8 years. In the evaluation 1 year after surgery, 133 (88.7%) patients had achieved complete response, 4 (2.7%) had a response, and in 13 (8.6%) there was no response. None of the analyzed preoperative variables was identified as a predictive factor of response at 1 year. Immediate responders after surgery (≥150,000 platelets/mL during the first week) had a higher platelet count and rate of complete response at 1 year (94.2%).
  
  
  CONCLUSIONS
  LS has a high success rate in patients with refractory ITP. Potential predictive indicators of success remain to be determined.
authors.affiliation: 1 Department of Surgery, "Salvador Zubirán" National Institute of Medical Sciences and Nutrition , Mexico City, Mexico .
authors.forename: Jorge
authors.initials: J
authors.lastname: Montalvo
authors.forename: David
authors.initials: D
authors.lastname: Velazquez
authors.forename: Juan P
authors.initials: JP
authors.lastname: Pantoja
authors.forename: Mauricio
authors.initials: M
authors.lastname: Sierra
authors.forename: Xavier
authors.initials: X
authors.lastname: López-Karpovitch
authors.forename: Miguel F
authors.initials: MF
authors.lastname: Herrera
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D012074:Remission Induction; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D013921:Thrombocytopenia / Q000601:surgery*; D016896:Treatment Outcome