Long-term outcome after laparoscopic splenectomy related to hematologic diagnosis |
| |
Authors: | C. Balagué E. M. Targarona G. Cerdán J. Novell O. Montero G. Bendahan A. García A. Pey S. Vela M. Diaz M. Trías |
| |
Affiliation: | (1) Service of General and Digestive Surgery, Hospital de Sant Pau, Autonomous University of Barcelona, Avda P Claret 167, 08025 Barcelona, Spain |
| |
Abstract: | Background Laparoscopic splenectomy (LS) has been demonstrated as an effective and safe treatment for hematological disorders requiring spleen removal, especially in cases of normal-sized spleens. However, although results are promising, long-term outcome data are lacking. We reviewed our clinical experience with LS in a series of 255 cases, with particular attention to the long-term outcome related to the disease process requiring LS.Methods From February 1993 to October 2003, LS was attempted in 255 patients (100 males and 155 females with a mean age of 45 ± 19 years) and clinical information was recorded in a prospective database. Indications for splenectomy included idiopathic thrombocytopenic purpura (ITP) (n = 115), HIV-ITP (n = 9), Evans syndrome (n = 6), autoimmune hemolytic anemia (AIHA) (n = 13), hereditary spherocytosis (HS) (n = 19), hematologic malignancy (n = 66), thrombotic thrombocytopenic purpura (n = 1), and others (n = 26). Long-term postoperative follow-up evaluation was obtained through clinical notes, follow-up visits by the referring hematologist, and by phone interviews both with patients and with the referring hematologist.Results A total of 186 patients (73%) were available for a mean follow-up of 35 months (range, 1–104). Of the ITP patients, 87 (76%) were followed up, with a remission rate of 89% (complete remission in 75%). A similar remission rate was observed in ITP-HIV; in patients available for follow-up (78%), complete remission was achieved in 83%. In Evans, complete remission was achieved in all patients available for follow-up (67%). Clinical response for hemolytic disease ranged between 70% for AIHA and 100% for HS. In the malignant group, the late mortality rate was 22%. The mortality rate in the miscellaneous group was 5%. No cases of splenectomy-related sepsis occurred during follow-up.Conclusions LS offers advantages for all types of splenic diseases requiring surgery. It provides not only good clinical short-term outcome but also satisfactory long-term hematological results.Paper presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), Los Angeles, California, USA, March 2003 |
| |
Keywords: | Splenectomy ITP long-term outcome |
本文献已被 PubMed SpringerLink 等数据库收录! |
|