Clinical Application of Laparoscopic Splenectomy for Idiopathic Thrombocytopenic Purpura

Objective To investigate the safety and efficacy of laparoscopic splenectomy (LS) performed for idiopathic thrombocytopenic purpura (ITP) . Methods From December 1999 to December 2004, LS was performed on 30 cases with ITP were analyzed by retrospectively. Results The successful laparoscopic operation was 93.3% with 2 cases converted to open splenectomy. The average duration of surgery was 130 min,estimated average blood loss was 100 ml,and peristalsis of alimentary tract was recovered within 24 hours after operation in all cases. All patients could get out of bed within 6 hours postoperatively. The average hospi-talization was 4. 5 days. Complications were occurred in 3 cases,of which 1 case developed subdiaphragmatic fluid collectiom, and other 2 cases developed subcutaneous emphysema. The early postoperative platelet count showed an immediate rise in almost all patients with CR + PR of 93. 3% . After mean 24 months of follow-up, 90% of patients after LS had normal platelet counts,3 patients relapsed and are still undergoing medical therapy. Conclusion Laparoscopic splenectomy is safe and technically feasible, and offers a minimally invasive and effective therapy for ITP.