Evaluation of Laparoscopic Splenectomy in Idiopathic Thrombocytopenic Purpura

Background: primary ITP was defined according to the American Society of Hematology 2011 evidence-based practice guideline as a platelet count less than 100 × 109 /L without other causes or disorders that may be associated with thrombocytopenia. The main first-line therapy for ITP is oral corticosteroids. Splenectomy is generally considered a second-line therapy in patients who are refractory to steroids and in those who relapse after an initial response to medical therapy. Objective: the aim of this study was to evaluate the feasibility, safety and efficacy of LS in ITP patients. Patients and Methods: this study was carried out on 20 patients diagnose as having ITP and indicated for splenectomy, 60% were females and 40% were males. Their age ranged from 17-33 years with a mean of 24.3± 5.39 years. Results: the platelet count raised from (30000 to 140000/L) pre-operative to (90000 to 190000/ L) post-operative. There was statistically significance difference between pre and post-operative platelet count (p <0.001). From the assessment of platelet count according to American Society of Hematology 2011 evidence-based practice guidelines for ITP. Nineteen patients (95%) achieved complete response, while only one patient (5%) achieved partial response. Conclusion: it was concluded that LS produces an adequate postoperative rise in platelet count and it is associated with less operating time, post-operative hospital stay, blood loss and postoperative complications.