LAPAROSCOPIC SPLENECTOMY FOR IDIOPATHIC THROMBOCYTOPENIC PURPURA

Objective To investigate the safety and efficacy of laparoscopic splenectomy(LS)in the treatment of idiopathic thrombocytopenic purpura(ITP).Methods Clinical data from 27 cases with ITP who underwent LS from July 2000 to July 2005 were analyzed retrospectively.The clinical data include pre-and postoperative platelet counts,intraoperative blood loss,recovery time,hospital stay time,and complications.Results Conversions to open splenectomy were required in 2 cases.LS was successful in 25 cases with an operative time of 75～230 min(mean,138 min)and operative blood loss of 20～350 ml(mean,97 ml).Accessory spleen was found and removed during the operation in 5 cases.All the patients got out of bed and had food within 2 days.Their mean hospitalization time was 5.4 days.Wound infection,incisional subcutaneous hematoma and subcutaneous emphysema occurred in 2,1 and 1 cases respectively.The time of follow-up was for 2.4～62 months(mean,22 months).17 cases were of complete response(68%)and 4 cases were of partial response(16%).Conclusion LS is a reltively safe and effective measure for treatment of ITP.