LAPAROSCOPIC SPLENECTOMY OFFERS ADVANTAGES IN SELECTED PATIENTS WITH IMMUNE THROMBOCYTOPENIC PURPURA

Citation
Rt. Schlinkert et D. Mann, LAPAROSCOPIC SPLENECTOMY OFFERS ADVANTAGES IN SELECTED PATIENTS WITH IMMUNE THROMBOCYTOPENIC PURPURA, The American journal of surgery, 170(6), 1995, pp. 624-627
Citations number
14
Categorie Soggetti
Surgery
ISSN journal
00029610
Volume
170
Issue
6
Year of publication
1995
Pages
624 - 627
Database
ISI
SICI code
0002-9610(1995)170:6<624:LSOAIS>2.0.ZU;2-L
Abstract
BACKGROUND: Splenectomy plays a crucial role in the management of sele cted patients with immune thrombocytopenic purpura (ITP). Laparoscopic splenectomy has been suggested as an alternative to open techniques. MATERIALS AND METHODS: A retrospective chart review was made for all p atients undergoing splenectomy for ITP at our institution from June 19 87 to August 1994. RESULTS: Twenty-one patients underwent splenectomy for ITP. Fourteen open procedures (group 1) and 7 laparoscopic procedu res (group 2) were performed. Eleven of 14 patients in group 1 and all 7 patients in group 2 had appropriate increases in platelet count fol lowing surgery. There were 3 complications in group 1 and no major com plications in group 2. Operative time was longer in group 2 (154 versu s 68 minutes, P <0.05), but decreased with experience (210 to 135 minu tes), Compared with patients in group 1, patients in group 2 tolerated liquids sooner (0.7 versus 2.6 days, P <0.05), required less parenter al narcotic (14 versus 65 morphine equivalents, P <0.05), and were dis charged sooner (2.1 versus 5 days, P <0.05). All patients in group 2 r emain well and require no medication after a mean follow-up of 11 mont hs. CONCLUSIONS: Laparoscopic splenectomy is safe and effective in the management of select patients with ITP and offers advantages over ope n techniques.