Document Detail

Results of laparoscopic splenectomy for immune thrombocytopenic purpura.
MedLine Citation:
PMID:  16850683     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the safety and efficacy of Laparoscopic Splenectomy (LS) for Immune Thrombocytopenic Purpura (ITP). MATERIAL AND METHOD: Twenty-five consecutive adult patients with chronic ITP who did not achieve sustained remission or refractory to medical treatment underwent elective LS between March 1995 and July 2005. The perioperative course was documented and the follow up data were recorded. RESULTS: All 25 patients underwent successful LS by a single surgeon. Twenty patients were available to analyze with a median follow-up time of 739 days (range, 18-3,555). The mean age was 29.8 years (range, 15-44) and 17 patients were female. The median preoperative platetlet count was 16,500/microL (range, 2,000-180,000). Accessory Spleens (AS) were removed in three patients (15%). A female patient died 24 days after LS from fungal brain abscesses. Fifteen patients (75%) had platelet count > 100,000/microL at initial response. Thirteen patients (65%) are in Complete Remission (CR) (platelet count > 100,000/microL). The probability of staying in CR after LS was 60.2% by Kaplan-Meier analysis. All failures occurred within 218 days of the operation. The mean age of the patients with CR was 27.2 years (range, 15-43) while the mean age of the nonCR was 34.7 years (range, 21-44). CONCLUSION: LS should be considered as a safe and effective therapy when elective splenectomy is indicated for chronic ITP patients.
Virachai Mahatharadol; Somchai Meesiri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  89     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-07-20     Completed Date:  2006-09-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  821-5     Citation Subset:  IM    
Department of Surgery, Rajavithi Hospital, Bangkok, Thailand.
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MeSH Terms
Chronic Disease
Disease Progression
Laparoscopy* / adverse effects
Prospective Studies
Purpura, Thrombocytopenic / immunology,  surgery*
Risk Assessment
Splenectomy / adverse effects,  methods*
Surgical Procedures, Elective
Treatment Outcome

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