Laparoscopic splenectomy in a pregnant patient with immune thrombocytopenic purpura

Felbinger, Thomas W.; Posner, M.; Eltzschig, Holger K.; Kodali, Bhavani Shankar

doi:10.1016/j.ijoa.2006.10.014

Cited by 20 publications

(12 citation statements)

References 18 publications

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“…131,132 Splenectomy may increase the risk of preterm labor during the first trimester and can be technically difficult because of the size of the uterus in the third trimester, but data regarding the magnitude of risk are lacking, as are data regarding the risks with laparoscopic splenectomy. 133 We identified no evidence for specific platelet thresholds at which pregnant patients with ITP should be treated; as with other patients, clinicians should consider the risks and benefits of any proposed treatment plans with a particular focus on major maternal complications including both those because of the ITP and those because of the drugs used to increase the platelet counts.…”

Section: Management Of Itp During Pregnancymentioning

confidence: 91%

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Neunert

Lim

Crowther

et al. 2011

Blood

1,664

1,783

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Immune thrombocytopenia (ITP) is commonly encountered in clinical practice. In 1996 the American Society of Hematology published a landmark guidance paper designed to assist clinicians in the management of this disorder. Since 1996 there have been numerous advances in the management of both adult and pediatric ITP. These changes mandated an update in the guidelines. This guideline uses a rigorous, evidence-based approach to the location, interpretation, and presentation of the available evidence. We have endeavored to identify, abstract, and present all available methodologically rigorous data informing the treatment of ITP. We provide evidence-based treatment recommendations using the GRADE system in those areas in which such evidence exists. We do not provide evidence in those areas in which evidence is lacking, or is of lower quality-interested readers are referred to a number of recent, consensus-based recommendations for expert opinion in these clinical areas. Our review identified the need for additional studies in many key areas of the therapy of ITP such as comparative studies of "front-line" therapy for ITP, the management of serious bleeding in patients with ITP, and studies that will provide guidance about which therapy should be used as salvage therapy for patients after failure of a first-line intervention. (Blood. 2011;117(16):4190-4207)

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Section: Management Of Itp During Pregnancymentioning

confidence: 91%

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Neunert

Lim

Crowther

et al. 2011

Blood

1,664

1,783

View full text Add to dashboard Cite

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“…Generally, it was agreed that when surgery must be performed in the presence of platelet counts <50 3 10 9 /L, platelet concentrates were transfused at the time of induction of anesthesia and precautions should be undertaken to minimize trauma to the upper airway during laryngoscopy for tracheal intubation [14]. Recently, two case reports described the anesthetic management in ITP patients with a very low platelet count [32,33]. In our series, 30 patients with platelet count <10 3 10 9 /L underwent uneventful endotracheal anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Splenectomy for Patients with Immune Thrombocytopenia and Very Low Platelet Count: Is Platelet Transfusion Necessary?

Chen

Peng

Cai

et al. 2011

Journal of Surgical Research

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“…Haemodynamic changes include decreases in the cardiac index and increases in mean arterial pressure and systemic vascular resistance [8]. Animal models, which have been used to evaluate the maternal and foetal effects of the increased intra-abdominal pressure associated with CO 2 pneumoperitoneum, have shown that there are no long-term adverse effects.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, this procedure had been avoided during pregnancy because of concerns that it could be harmful to the foetus. However, the evidence accumulated over the last decade [4][5][6][7][8][9][10] suggests that the clinical outcomes of this technique are equivalent to those of open surgery, but with all the advantages of the laparoscopic approach. This paper outlines the case of a pregnant woman diagnosed with bilateral dermoid cysts which was successfully managed with laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

Bilateral ovarian laparoscopic cystectomy of dermoid cysts and pregnancy

et al. 2009

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Significant ovarian masses complicate 0.2% to 2% of pregnancies. Although the risk of malignancy is low, complications resulting from distention, rupture and/or torsion of the adnexa can be a significant concern. As laparoscopic procedures improve and our experience with laparoscopy in pregnant women increases, more and more patients with these complications find that they can forego laparotomy and manage their condition safely through laparoscopic removal of the mass. The subject of the case study presented here was a 39-year-old woman diagnosed with bilateral adnexal masses during the first trimester of pregnancy. A bilateral ovarian laparoscopic cystectomy was performed at 16 weeks with a favourable outcome. The pathological diagnosis was "mature cystic teratoma" on both sides. This case demonstrates that laparoscopic surgery can be performed safely and effectively in pregnant women with an adnexal mass.

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Laparoscopic splenectomy in a pregnant patient with immune thrombocytopenic purpura

Cited by 20 publications

References 18 publications

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Laparoscopic Splenectomy for Patients with Immune Thrombocytopenia and Very Low Platelet Count: Is Platelet Transfusion Necessary?

Bilateral ovarian laparoscopic cystectomy of dermoid cysts and pregnancy

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