Laparoscopic versus open splenectomy for immune thrombocytopenic purpura

Watson, David I.; Coventry, Brendon J.; Chin, Terence; Gill, P. Grantley; Malycha, Peter

doi:10.1016/s0039-6060(97)90177-x

Cited by 142 publications

(111 citation statements)

References 7 publications

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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: Discussionsupporting

confidence: 56%

“…Spontaneous remission without treatment occurs in >80% and splenectomy is nearly always curative in pediatric patients. [18,24,25] But in adults, relapse is likely to occur even after medical treatment and splenectomy. There is no standardized definition for remission of ITP and duration of follow-up after which it can be defined as complete remission.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

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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“…13 Several recent studies have compared open with laparoscopic splenectomy for ITP. [19][20][21][22][23][24][25] Together these series describe 169 patients who underwent open splenectomy. The early postoperative complication rate was estimated to be 22%.…”

Section: Discussionmentioning

confidence: 99%

Morbidity and mortality in adults with idiopathic thrombocytopenic purpura

Portielje

Westendorp

Kluin-Nelemans

et al. 2001

Blood

450

391

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To study outcomes of adults with idiopathic thrombocytopenic purpura (ITP), we performed a follow-up study in a cohort of 152 consecutive patients who were treated according to a well-defined algorithm. Longterm outcomes were determined relative to the response 2 years after diagnosis, because most (93%) patients who ultimately attained platelet counts above 30.0 ؋ 10 9 /L (30 000/L) did so within this time frame. Complete follow-up for mortality could be studied in 99% of patients and for morbidity in 95% of patients, with a mean of 10.5 years. Within 2 years after diagnosis, 4 patients died, 2 were lost to follow-up, and 12 were reclassified as having secondary immune thrombocytopenia. Of the remaining 134 patients, 114 (85%) had obtained platelet counts above 30.0 ؋ 10 9 /L while all therapies had been discontinued. These patients had a long-term mortality risk equal to the general population. Twelve of 134 patients (9%), all with severe thrombocytopenia, had refractory disease and suffered a mortality risk of 4.2 (95% confidence interval, 1.7-10.0). Bleeding and infection equally contributed to the death of these patients. Another 8 patients (6%) had platelet counts above 30.0 ؋ 10 9 /L while on maintenance therapy. Similar to patients with refractory disease, these latter patients had considerably increased ITPrelated hospital admissions, but mortality was only slightly higher than in the general population. In conclusion, most adults with ITP have a good outcome with infrequent hospital admissions and no excess mortality.

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“…There has been debate over whether imaging for accessory spleens is necessary. 11,16,22,25 However, the sensitivity and specificity of computed tomography (CT) for detecting accessory spleens is 60% and 95.6%, respectively, whereas that of laparoscopic detection is 93.3% and 100%, respectively. Perioperative CT for the detection and localization of accessory spleens may not be necessary.…”

Section: Preoperative Planningmentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15] Currently, minimally invasive splenectomy is successfully performed for a variety of conditions, including idiopathic thrombocytopenic purpura, hereditary spherocytosis, autoimmune hemolytic anemia, thrombocytopenic purpura, Hodgkin and non-Hodgkin lymphoma, chronic lymphocytic leukemia, hemangiomas, idiopathic myelofibrosis, myelodysplastic syndrome, hairy cell leukemia, splenic abscess or cyst, and tuberculosis. 7,11,16,17 Other indications may include blunt trauma. 18 Contraindications to performing LS include uncorrected coagulopathies and severe portal hypertension from liver cirrhosis.…”

mentioning

confidence: 99%