title: Late results after splenectomy in adult idiopathic thrombocytopenic purpura.
abstract: BACKGROUND
  We performed a retrospective study on patients with idiopathic thrombocytopenic purpura (ITP) to evaluate the response to splenectomy in relation to preoperative platelet count.
  
  
  METHODS
  Two groups of patients operated on with laparoscopic or open splenectomy for ITP, with a platelet count ≤30,000/μL (study group: 22 patients) and >30,000/μL (control group: 18 patients), respectively, were compared. The two groups were homogeneous in relation to age, sex, length of preoperative steroid therapy, and time interval between diagnosis and surgery (Student t test with P > .1). The results of surgery were evaluated at one year after splenectomy. Positive response to surgery, according to the American Society of Hematologic Guidelines, was considered in patients with a postoperative platelet count ≥100,000/μL or in patients with a postoperative platelet count ≥30,000/μL and a twofold increase in platelet count from baseline, in the absence of bleeding. The postoperative platelet count increase rate was statistically related to preoperative platelet count in both the study and control groups. Statistical analysis was performed using the Student's t test for independent sample and the Pearson correlation in a 2-tailed test.
  
  
  RESULTS
  No relationship between preoperative platelet count and postoperative platelet percent increase was observed in the control group (r = -0.41; P = .089), whereas a significant negative correlation (r = -0.68; P = .0004) was found in the study group.
  
  
  CONCLUSIONS
  A higher increase of postoperative percent platelet count may be predicted in patients with a low preoperative platelet count.
authors.affiliation: Department of Surgery, University of Catania, Italy, Catania, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Vecchio
authors.affiliation: Department of Surgery, University of Catania, Italy, Catania, Italy.
authors.forename: Eva
authors.initials: E
authors.lastname: Intagliata
authors.affiliation: Department of Surgery, University of Catania, Italy, Catania, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: La Corte
authors.affiliation: Department of Surgery, University of Catania, Italy, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Marchese
authors.affiliation: Hematologic Unit, Department of Biomedical Science, University of Catania, Catania Italy.
authors.forename: Rossella R
authors.initials: RR
authors.lastname: Cacciola
authors.affiliation: Hematologic Unit, Department of Biomedical Science, University of Catania, Catania Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Cacciola
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011184:Postoperative Period; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood* / Q000601:surgery*; D012189:Retrospective Studies; D013156:Splenectomy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Idiopathic thrombocytopenic purpura; Laparoscopic splenectomy; Splenectomy
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