Are the favorable outcomes of splenectomy predictable inpatients with idiopathic thrombocytopenic purpura (ITP)?

Tsereteli, Zurab; Smith, C. Daniel; Branum, Gene D.; Galloway, John R.; Amerson, R.J.; Chakaraborty, H.; Hunter, John G.

doi:10.1007/s00464-001-8154-2

Cited by 21 publications

(33 citation statements)

References 14 publications

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“…It can be concluded that a more successful disease outcome following splenectomy can be predicted for younger patients. Tsereteli et al write that the duration of the disease prior to the operation is also one of the predictive factors, which should be considered for successful ITP outcome following splenectomy (22). In our study the mean value of the duration of the disease prior the operation (45 ± 54.4 months) did not influence the disease outcome following the operation in a statistically significant way (ANOVA; F = 0.297; p = 0.750).…”

Section: Discussioncontrasting

confidence: 50%

“…The side -effects of GC therapy and the development of minimally invasive surgical techniques facilitated the introduction of laparoscopic splenectomy in the treatment of ITP. 50 -80 % of the patients are treated with splenectomy, and achieve full remission following the operation in 49 -93 % of the cases, therefore various perioperative predictive factors are searched that would allow predicting ITP outcome after the operation (3,9,14,22,23). If 30 days after the operation and longer PLT count is > 150 x 10 9 /L (more recent publications > 100 x 10 9 /L), without additional therapy, except cases, when GC dose is gradually cancelled after the operation, the remission is considered to be complete.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical technique has no impact upon ITP outcome following the operation (3,7,12,14,16). Various sources of literature mention the range of ITP remission following splenectomy from 49 -93% (3,9,14,22,23). Current studies are looking for prognostic factors, which would ensure complete ITP remission following splenectomy (2,3,8,9,13,17,20,23).…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Predictive Factors Following Splenectomy for Complete Remission of Immune Thrombocytopenic Purpura

Vidmane-Ozola¹,

Boka²,

Cunskis

et al. 2010

Acta Chirurgica Latviensis

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28Summary Introduction. Immune thrombocytopenic purpura (ITP) is one of the most commonly known and widely researched haematological diseases. ITP manifests as decrease in platelet count of various degrees, which can even cause fatal bleeding from 0.4 -13% annually. Glucocorticoids (GC) and intravenous immunoglobulin (IgG) are used as the first line of treatment, 20-50% of drug therapy is ineffective and splenectomy is "the second stage" of treatment. Various sources of literature mention the range of ITP remission following splenectomy from 49 -93%. Current studies are looking for prognostic factors, which would ensure complete ITP remission following splenectomy. Aim of the Study. To analyse possible perioperative prognostic factors in ITP patients for achieving remission following splenectomy. Materials and methods. The retrospective study included 13 patients diagnosed with immune thrombocytopenic purpura (ITP), who underwent surgery in the period from 2002 to 2009 at the Riga Eastern Clinical University Hospital "Linezers". From laboratory tests -full blood-count 1 -2 days before the operation, on the 5th -7th day following the operation, 1 month after the operation, one year after the operation and during the last follow-up found in the patient's out-patient file. The size of the spleen before the surgery was determined by ultrasonography. The access to the abdominal cavity and the spleen -conventional or laparoscopic surgery, the duration of the operation, perioperative blood loss, post-operative complications and the patient's day of discharge following the surgery was analysed. Results. In the period from January 2002 to January 2009 at RECUH clinic "Linezers" 13 ITP patients underwent surgery. As to the gender the average age for both genders was similar (men 39.0 ± 14.1 and women 39.0 ± 16.0). The mean value of the duration of the disease in women (8.0 ± 9.0 months) and men (68.1 ± 58.7 months) has a statistically significant difference, using the independent pair selection t-test (t = 2.38; p = 0.047). In one US case and in one CT case accessory spleens were detected. The preoperative mean value of PLT count had increased in a statistically significant way in accordance with the independent pair selection t-test (t = 3.087; p = 0.009), and in accordance with Wilcoxon signed-rank test (z = 2,202; p = 0,028) compared to the mean value of PLT count, which was detected during the last follow-up visit on average 35.9 ± 35.9 months after the surgery. Analysis of variance (ANOVA) shows that the average age of cured patients 34.6 ± 9.8 is statistically less significant than for those patients, who continue treatment and whose disease has transformed (F = 7.327; p = 0.011). Conclusions. The performed research allows concluding that the decisive factors in successful ITP outcome after the operation are the following: 1) in patients, who have undergone the operation in a relatively younger age (34.6 ± 9.8 years) the disease outcome is more successful during the follow -up period -35.9 ± 35.9 months (F = 7.327; ...

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perioperative Predictive Factors Following Splenectomy for Complete Remission of Immune Thrombocytopenic Purpura

Vidmane-Ozola¹,

Boka²,

Cunskis

et al. 2010

Acta Chirurgica Latviensis

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“…The good longterm results obtained after LS for ITP have revived interest in ITP as surgical disease. Several studies have attempted to investigate the predictive factors for success after LS [11,28]. Lower response has been reported in patients older than 40 years of age with long-term corticoid treatment or a post-splenectomy platelet count lower than 100 · 10 9 /L, and these variables have been considered as predictive factors of poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome after laparoscopic splenectomy related to hematologic diagnosis

et al. 2004

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“…But the overall complication rate is low in LS. [24,30] As our study, Tsereteli et al, [31] did not find any significant difference between the open and laparoscopic procedures as a predictive factor of favorable outcome.…”

Section: Discussionmentioning

confidence: 50%

Long-term Relapse-free Rurvival Rate and Predictive Factors of Idiopathic Thrombocytopenic Purpura in Adults Undergoing Splenectomy

Liu¹,

Dilip²,

Yeh³

et al. 2013

Biomed J

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Are the favorable outcomes of splenectomy predictable inpatients with idiopathic thrombocytopenic purpura (ITP)?

Cited by 21 publications

References 14 publications

Perioperative Predictive Factors Following Splenectomy for Complete Remission of Immune Thrombocytopenic Purpura

Perioperative Predictive Factors Following Splenectomy for Complete Remission of Immune Thrombocytopenic Purpura

Long-term outcome after laparoscopic splenectomy related to hematologic diagnosis

Long-term Relapse-free Rurvival Rate and Predictive Factors of Idiopathic Thrombocytopenic Purpura in Adults Undergoing Splenectomy

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