Keidar A, Sagi B, Szold A. Laparoscopic Splenectomy for Immune Thrombocytopenic Purpura in Patients with Severe Refractory Thrombocytopenia.
PATHOPHYSIOLOGY OF HAEMOSTASIS AND THROMBOSIS 2003;
33:116-9. [PMID:
14624054 DOI:
10.1159/000073856]
[Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2002] [Accepted: 03/06/2003] [Indexed: 11/19/2022]
Abstract
Laparoscopic splenectomy (LS) for immune thrombocytopenic purpura has a success rate of 70-90%. This invasive procedure is sometimes required for patients with refractory thrombocytopenia. However, no data on their outcome are available. If the hematologic response is inadequate, its value vis-à-vis the risk associated with major surgery is open to question. Twelve of 110 patients who underwent LS in our institution had a platelet count lower than 20 x 10(9)/l (mean 6.6 x 10(9)/l). Nine patients (75%) had a good-to-excellent hematologic response. The complication rate was 33%. LS in patients with very low platelet counts is feasible and yields a response rate similar to the average of patients with immune thrombocytopenic purpura. However, it bears a higher perioperative morbidity compared with LS in patients with higher counts.
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