Application of laparoscopic splenectomy in treatment of refactory idiopathic thrombocytopenic purpura

Objective To investigate the safety and efficacy of laparoscopic splenectomy(LS) in treatment of refractory idiopatic thrombocytopenic purpura(ITP).Methods The clinical data of 18 patients with ITP underwent LS from 2002 to 2006 were analyzed retrospectively.Results One case was converted to open surgery.Seventeen patients successfully underwent LS.The mean operation time was 92(52-172)minutes,and intraoperative mean blood loss was 102(30500)mL.At operation an accessory spleen was found in 3 cases and it was excised.The platelet count was elevated rapidly in one week postoperatively,and peristalsis of alimentary tract recovered in 12 to 24 hours after operation in all cases.The mean hospitalization time was 8 days.Complication(puncture of abdominal wall caused bleeding) occurred in two cases.Seventeen patients were followed up for 2-37months,one patient relapsed.Conclusions LS is a relatively safe and effective measure for treatment of ITP.