Application of laparoscopic splenectomy for refractory idiopathic thrombocytopenic purpura

Objective To evaluate the safety and efficacy of laparoscopic splenectomy in the treatment of refractory idiopathic thrombocytopenic purpura(ITP).Methods Forty-two cases of refractory ITP were analyzed retrospectively to investigate the efficacy of laparoscopic splenectomy.Results 95.2% of the patients underwent laparoscopic splenectomy successfully and only two cases were converted to open procedure.The average duration of operation was 105 minutes,and the average intraoperative blood loss was 40 mL.Peristalsis of gastrointestinal tract was rehabilitated postoperatively within 12-24 hours in all cases.The mean length of hospital stay was 5 days.The platelet count increased rapidly in one week post operation.The curative effective rate of the operation was 95.2%.Complications occurred in 3 cases,one of which was subphrenic effusion,and the remaining 2 were subcutaneous emphysema.38 patients were followed but 4 were lost to followed-up.3 patients relapsed.The total response rate was 88.1%.Conclusion Laparoscopic splenectomy for ITP is safe and feasible,and achieves significant clinical effectiveness.