Objective. To describe the perioperative characteristics, complication
s and outcome of the first 22 patients who underwent laparoscopic sple
nectomy for refractary/recurrent ITP in our institution. Material and
methods. Clinical and biochemical characteristics, spleen size, indica
tion for surgery, operative time, blood requirements, complications an
d outcome of 22 patients who underwent laparoscopic splenectomy betwee
n 1994 and 1997 were prospectively recorded. Their mean age was 40 +/-
15 (+/- SD), 15 females and 7 males. Results. The preoperative platel
et count was 56 thousand +/- 58.7/uL average spleen size 10.5 +/- 2 cm
. The surgical time averaged 4.5 +/- 1 hours; accessory spleens were r
emoved from two patients. Conversion to the open procedure was necessa
ry in two cases. Complete response was achieved in 59%, partial respon
se in 27%, and no response in 14% (none of these due to missed accesso
ry spleens). Six patients developed complications. One of them died tw
o days after surgery. The mean postoperative stay was 4.7 +/- 2.6 days
. Conclusions. The results of laparoscopic splenectomy were similar to
our previous results with the open approach. The laparoscopic techniq
ue took longer in our hands but the postoperative stay was shorter.