Laparoscopic splenectomy for idiopathic thrombocytopenic purpura: Comparison of laparoscopic surgery and conventional open surgery

Makoto Hashizume, Masayuki Ohta, Fumiaki Kishihara, Hirofumi Kawanaka, Morimasa Tomikawa, Kiichiro Ueno, Kazuo Tanoue, Hidefumi Higashi, Seigo Kitano, Keizo Sugimachi

Research output: Contribution to journalReview articlepeer-review

45 Citations (Scopus)

Abstract

In chronic idiopathic thrombocytopenic purpura (ITP), the two main therapeutic choices are steroid treatment or splenectomy. The adult form of ITP is described as a disease found primarily in young adults, with a female predominance. Treatment with steroids effects a complete response in less than 30% of patients, whereas splenectomy is successful in more than 60% of patients who undergo it. The minimal access afforded by laparoscopic splenectomy is considered highly desirable for these patients. The purpose of this study was to compare the clinical benefits of a laparoscopic splenectomy with those of conventional open surgery for patients with ITP. From 1968 to 1993, splenectomy was performed on 51 patients: 10 operations done laparoscopically and 41 performed conventionally. Complications, postoperative pain, recovery, and hospital charges were then compared. Laparoscopic splenectomy involved minimal incisions, and a significantly lower frequency of analgesia was required for postoperative abdominal pain (1.3 vs. 3.3); hospital stay was shorter (8.2 vs. 20.1 days) (p < 0.005). Operative time was significantly longer for the laparoscopic surgery (249.2 vs. 99.8 min) (p < 0.0001), but blood loss was less (176.0 vs. 511.7 g) (p < 0.01). No intraoperative or postoperative major complications occurred with the laparoscopic procedures, compared with 46.3% with conventional surgery. Finally, the total hospital costs were lower with laparoscopic splenectomy, especially for postoperative care (p < 0.05). A laparoscopic splenectomy may well be considered the surgical treatment of choice for patients requiring a splenectomy in view of both quality of life and economy.

Original languageEnglish
Pages (from-to)129-135
Number of pages7
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume6
Issue number2
DOIs
Publication statusPublished - 1996

All Science Journal Classification (ASJC) codes

  • Surgery

Fingerprint Dive into the research topics of 'Laparoscopic splenectomy for idiopathic thrombocytopenic purpura: Comparison of laparoscopic surgery and conventional open surgery'. Together they form a unique fingerprint.

Cite this