Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia.

Abstract

PURPOSE:

Splenectomy is the standard therapy for medically refractory immune thrombocytopenia (ITP). Laparoscopic splenectomy (LS) has gained wide acceptance; however, the long-term outcomes of LS versus open splenectomy (OS) for patients with ITP remain unclear.

METHODS:

We analyzed, retrospectively, 32 patients who underwent splenectomy, as LS in 22 and OS in 10, for refractory ITP at our institute. Data were evaluated based on the American Society of Hematology 2011 evidence-based practice guidelines for ITP.

RESULTS:

Although the operation time was significantly longer in the LS group (p < 0.01), LS was associated with less blood loss (p < 0.01), infrequent blood transfusion during surgery (p < 0.01), quicker resumption of oral intake (p < 0.01), and shorter hospital stay (p < 0.01) than OS. Positive responses, including complete and partial remission, were achieved in 90% of the OS group patients and 77% of the LS group patients. The mean follow-up periods were 183 and 92 months, respectively. Relapse-free survival rates, 15 years after the operation were 63% in the OS group and 94% in the LS group.

CONCLUSIONS:

LS can provide better short-term results and comparable long-term results to those of OS for ITP.

• Authors: Kazuhiro Tada, Masayuki Ohta, Kunihiro Saga, Hiroomi Takayama, Teijiro Hirashita, Yuichi Endo, Hiroki Uchida, Yukio Iwashita, Masafumi Inomata
• Journal: Surgery today (Surg Today) Vol. 48 Issue 2 Pg. 180-185 (Feb 2018) ISSN: 1436-2813 [Electronic] Japan
• PMID: 28726165 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Female
• Humans
• Laparoscopy (methods)
• Male
• Middle Aged
• Purpura, Thrombocytopenic, Idiopathic (surgery)
• Retrospective Studies
• Splenectomy (methods)
• Time Factors
• Treatment Outcome
• Young Adult