Splenectomy for idiopathic thrombocytopenic purpura |
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Authors: | A Marassi A Vignali W Zuliani E Biguzzi C Bergamo L Gianotti V Di Carlo |
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Institution: | (1) IRCCS San Raffaele, Department of Surgery, University of Milan, Italy, IT;(2) Centro Emofilia e Trombosi: IRCCS Maggiore Hospital, Milan, Italy, IT |
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Abstract: | Background: This study aimed to compare the safety, efficacy, and clinical benefits of laparoscopic splenectomy (LS) to open splenectomy
(OS) in patients 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 platelet counts were evaluated,
as were details of the surgical procedure, postoperative 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 response 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 underwent 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 conventional splenectomy in the treatment of ITP.
Received: 10 October 1997/Accepted: 11 March 1998 |
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Keywords: | : Laparoscopic surgery — Splenectomy — Immune thrombocytopenic purpura — Hematologic disease |
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