Splenectomy for idiopathic thrombocytopenic purpura - Comparison of laparoscopic and conventional surgery

Background: This study aimed to compare the safety, efficacy, and clinical benefits of laparoscopic splenectomy (LS) to open splenectomy (OS) in patie nts with idiopathic thrombocytopenic purpura (ITP). Methods: The results from 14 consecutive patients who underwent LS for ITP were reviewed and compared with the results from patients who underwent OS for the same disease. Demographics, concomitant disease on admission, and p latelet counts were evaluated, as were details of the surgical procedure, p ostoperative physiologic status, and hospital stay. Results: Mean operative time was 88.3 min for OS and 146.4 min in LS group (p < 0.05). The conversion rate to open splenectomy was 7.1. Therapeutic re sponse to splenectomy was 92.8% in the LS group and 86.6% in the OS group. Bowel canalization, return to Liquid diet, and length of hospital stay were all significantly delayed in the OS group as compared with those who under went LS (p = 0.01, p = 0.02, p = 0.005, respectively). In the OS group the morbidity rate was 13.3%, whereas in the LS group it was 7.1%. Conclusions: Laparoscopic splenectomy represents a valid alternative to con ventional splenectomy in the treatment of ITP.