Laparoscopic Splenectomy

Katkhouda, Namir; Hurwitz, Michael; Rivera, Raymond T.; Chandra, Mudjianto; Waldrep, Donald J.; Gugenheim, Jean; Mouïel, J

doi:10.1097/00000658-199810000-00013

Cited by 205 publications

(58 citation statements)

References 39 publications

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“…Another recent series of 103 patients found no perioperative deaths, six postoperative complications, and four conversions to open splenectomy in the group [15]. In this heterogeneous group of patients, seven of ten patients who had autoimmune hemolytic anemia were said to have a significant increase in hematocrit after surgery [15]. It is not documented if any of these ten patients carried a concomitant diagnosis of CLL.…”

Section: Discussionmentioning

confidence: 92%

“…They reported a 5% rate of conversion to open splenectomy, a 16% rate of postoperative complications, and only one death [8]. Another recent series of 103 patients found no perioperative deaths, six postoperative complications, and four conversions to open splenectomy in the group [15]. In this heterogeneous group of patients, seven of ten patients who had autoimmune hemolytic anemia were said to have a significant increase in hematocrit after surgery [15].…”

Section: Discussionmentioning

confidence: 98%

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Laparoscopic splenectomy for autoimmune hemolytic anemia in patients with chronic lymphocytic leukemia: A case series and review of the literature

et al. 2004

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The purpose of this study was to evaluate the safety and efficacy of laparoscopic splenectomy in patients with chronic lymphocytic leukemia (CLL) complicated by autoimmune hemolytic anemia. A series of nine such patients who underwent this procedure at our institution between August 1997 and September 2001 were retrospectively reviewed. Seven of 9 patients who underwent laparoscopic splenectomy for CLL and autoimmune hemolytic anemia achieved a complete response. One patient who initially responded relapsed 12 weeks postoperatively. Therefore, six of 9 patients showed sustained responses with a mean follow‐up of 2 years, consistent with other published series. Two patients had no response, one of whom died within 3 weeks of surgery from transformed Hodgkin's disease. The only other postoperative complication occurred in a patient who developed pneumonia. We conclude that laparoscopic splenectomy is a safe and effective treatment for autoimmune hemolytic anemia in patients with CLL who fail medical therapy. Am. J. Hematol. 75:134–138, 2004. © 2004 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Laparoscopic splenectomy for autoimmune hemolytic anemia in patients with chronic lymphocytic leukemia: A case series and review of the literature

et al. 2004

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“…İTP'li hastalarda splenektomi sonrası sintigrafi ile tespit edilen geride kalan dalak dokusu (aksesuar dalak) oranı %12-48 arasında değişmektedir (12,22,23). Bizim serimizde 4 (%11) hastada aksesuar dalak saptandı.…”

Section: Gereç Ve Yöntemlerunclassified

“…Aksesuar splenektomi genellikle trombositopeniyi düzeltir (12,25). Fakat bu her zaman geçerli değildir (12,22,26). Her splenektomide sistematik dalak taraması, ikincil bir ameliyat gerekliliğini ortadan kaldırmak için ameliyatın bir parçası olmalıdır (12).…”

Section: Gereç Ve Yöntemlerunclassified

“…Kortikosteroidler ile birincil medikal tedaviye yanıtsızlık ya da güvenli trombosit seviyesini sürdürmek için devamlı tedavi ihtiyacı olması durumlarında splenektomi ikincil olarak düşünülmelidir (1,3,10,11). İTP tedavisinde splenektomi ilk olarak Kaznelson tarafından 1916 yılında yapılmıştır (15,16). Bu tarihten beri uygulanan splenektomi İTP'li hastaların tedavisinde halen tek küratif tedavi olmayı sürdürmektedir (3).…”

Section: Introductionunclassified

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Recurrence in immune thrombocytopenic purpura after splenectomy

Tan¹,

Görgün²,

Karaca³

et al. 2012

Gaziantep Med J

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ÖzetÇalışmamızda, immun trombositopenik purpura nedeniyle splenektomi yapılan hastalarda, yineleme oranı ve buna etki eden nedenleri değerlendirip sonuçları literatür eşliğinde tartışmayı amaçladık. İmmun trombositopenik purpura nedeni ile splenektomi yapılan 36 hasta çalışma kapsamına alındı. Hastalar yaş ve cinsiyet yönünden değerlendirildi. Takipli olan 25 hasta ortalama 24 ay izlendi. Yineleme oranı ve buna etki edebilecek nedenler olarak ameliyatın açık veya kapalı olması, cinsiyet, yaş, ameliyat öncesi ve sonrası 2. gün trombosit değerleri değerlendirilerek literatür eşliğinde tartışıldı. On üç hasta (%36,1) erkek, 23 hasta (% 63,9) hasta kadın idi. Ortalama yaş 37,7 idi. Aksesuar dalak 4 hastada (%11,1) bulundu. İzlenen 25 hastanın, 5'inde (%20) yineleme, 1'inde (%4) ise parsiyel yineleme saptandı. Kadınlarda ve 40 yaş üzerindekilerde yineleme oranı fazla olsa da istatistiksel olarak anlamlı değildi. Ameliyat sonrası 2. gün alınan trombosit değeri 156000/ml altında olanlarda, bu değerin üstünde olanlara göre yineleme oranı fazla ve istatistiksel olarak anlamlı idi (p=0,024). İmmun trombositopenik purpura cerrahi tedavisinde yinelemeyi tamamen önlemek en iyi şartlarda dahi mümkün olamamaktadır. Bu nedenle ameliyat sonrası 2. gün alınan trombosit değerleri ile yineleme olabilecek hastaları saptayıp daha sık kontrol altında tutmanın yerinde olacağını düşünmekteyiz. Anahtar kelimeler: İmmun trombositopenik purpura; nüks; splenektomi; yineleme AbstractIn our study, we aimed to evaluate and discuss the recurrence rate and the causes for recurrences in splenectomy due to immune thrombocytopenic purpura. Thirty-six patients who had splenectomy due to immune thrombocytopenic purpura, enrolled in the study. Patients were evaluated for age and gender. Twenty-five patients were followed at a mean of 24 months. Recurrence rate and causes for recurrences; laparoscopic or open surgery, gender, age, preoperative and postoperative 2nd day platelet count were evaluated and discussed with the data in the literature. Thirteen patients (36.1%) were male and 23 patients (63.9%) patients were female. Mean age was 37,7. Accessory spleen was found in 4 patients (11.1%). In the follow-up of 25 patients, 5 patients (20%) had recurrence, 1 patient (4%) had partial recurrence. Although the recurrence rate was higher in woman and over 40 year old group, this was not statistically significant. The recurrence rate of patients, whose platelet count below 156.000/ml in postoperatively 2nd day, was significantly more than the patients whose platelet count above this value (p=0,024). Even under the best conditions, it is not possible to completely avoid the recurrences in surgical treatment of immune thrombocytopenic purpura. Therefore, we think it would be helpful to identify the patients with postoperatively 2nd day platelet count who have possibility for recurrence and keep those under control more often.

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Laparoscopic vs Open Splenectomy

Park¹

1999

Arch Surg

140

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Hypothesis: Laparoscopic splenectomy (LS) provides health benefits to patients compared with open splenectomy (OS) in terms of perioperative morbidity, complications, and patient recuperation.Design: Prospective operative and outcome data of LS patients were compared with those of OS patients (historical controls).Setting: Data were gathered, and patients were evaluated and treated at 2 McMaster University teaching hospitals in Hamilton, Ontario, and at the University of Kentucky Chandler Medical Center, Lexington, also a teaching hospital.

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Laparoscopic Splenectomy

Cited by 205 publications

References 39 publications

Laparoscopic splenectomy for autoimmune hemolytic anemia in patients with chronic lymphocytic leukemia: A case series and review of the literature

Laparoscopic splenectomy for autoimmune hemolytic anemia in patients with chronic lymphocytic leukemia: A case series and review of the literature

Recurrence in immune thrombocytopenic purpura after splenectomy

Laparoscopic vs Open Splenectomy

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