Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia

Kazuhiro Tada, Masayuki Ohta, Kunihiro Saga, Hiroomi Takayama, Teijiro Hirashita, Yuichi Endo, Hiroki Uchida, Yukio Iwashita, Masafumi Inomata

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Splenectomy is the standard therapy for medically refractory immune thrombocytopenia (ITP). Laparoscopic splenectomy (LS) has gained wide acceptance; however, the long-term outcomes of LS versus open splenectomy (OS) for patients with ITP remain unclear. Methods: We analyzed, retrospectively, 32 patients who underwent splenectomy, as LS in 22 and OS in 10, for refractory ITP at our institute. Data were evaluated based on the American Society of Hematology 2011 evidence-based practice guidelines for ITP. Results: Although the operation time was significantly longer in the LS group (p < 0.01), LS was associated with less blood loss (p < 0.01), infrequent blood transfusion during surgery (p < 0.01), quicker resumption of oral intake (p < 0.01), and shorter hospital stay (p < 0.01) than OS. Positive responses, including complete and partial remission, were achieved in 90% of the OS group patients and 77% of the LS group patients. The mean follow-up periods were 183 and 92 months, respectively. Relapse-free survival rates, 15 years after the operation were 63% in the OS group and 94% in the LS group. Conclusions: LS can provide better short-term results and comparable long-term results to those of OS for ITP.

Original languageEnglish
Pages (from-to)180-185
Number of pages6
JournalSurgery today
Volume48
Issue number2
DOIs
Publication statusPublished - Feb 1 2018
Externally publishedYes

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Idiopathic Thrombocytopenic Purpura
Splenectomy
Evidence-Based Practice
Practice Guidelines
Blood Transfusion

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Tada, K., Ohta, M., Saga, K., Takayama, H., Hirashita, T., Endo, Y., ... Inomata, M. (2018). Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia. Surgery today, 48(2), 180-185. https://doi.org/10.1007/s00595-017-1570-2

Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia. / Tada, Kazuhiro; Ohta, Masayuki; Saga, Kunihiro; Takayama, Hiroomi; Hirashita, Teijiro; Endo, Yuichi; Uchida, Hiroki; Iwashita, Yukio; Inomata, Masafumi.

In: Surgery today, Vol. 48, No. 2, 01.02.2018, p. 180-185.

Research output: Contribution to journalArticle

Tada, K, Ohta, M, Saga, K, Takayama, H, Hirashita, T, Endo, Y, Uchida, H, Iwashita, Y & Inomata, M 2018, 'Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia', Surgery today, vol. 48, no. 2, pp. 180-185. https://doi.org/10.1007/s00595-017-1570-2
Tada, Kazuhiro ; Ohta, Masayuki ; Saga, Kunihiro ; Takayama, Hiroomi ; Hirashita, Teijiro ; Endo, Yuichi ; Uchida, Hiroki ; Iwashita, Yukio ; Inomata, Masafumi. / Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia. In: Surgery today. 2018 ; Vol. 48, No. 2. pp. 180-185.
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AU - Hirashita, Teijiro

AU - Endo, Yuichi

AU - Uchida, Hiroki

AU - Iwashita, Yukio

AU - Inomata, Masafumi

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N2 - Purpose: Splenectomy is the standard therapy for medically refractory immune thrombocytopenia (ITP). Laparoscopic splenectomy (LS) has gained wide acceptance; however, the long-term outcomes of LS versus open splenectomy (OS) for patients with ITP remain unclear. Methods: We analyzed, retrospectively, 32 patients who underwent splenectomy, as LS in 22 and OS in 10, for refractory ITP at our institute. Data were evaluated based on the American Society of Hematology 2011 evidence-based practice guidelines for ITP. Results: Although the operation time was significantly longer in the LS group (p < 0.01), LS was associated with less blood loss (p < 0.01), infrequent blood transfusion during surgery (p < 0.01), quicker resumption of oral intake (p < 0.01), and shorter hospital stay (p < 0.01) than OS. Positive responses, including complete and partial remission, were achieved in 90% of the OS group patients and 77% of the LS group patients. The mean follow-up periods were 183 and 92 months, respectively. Relapse-free survival rates, 15 years after the operation were 63% in the OS group and 94% in the LS group. Conclusions: LS can provide better short-term results and comparable long-term results to those of OS for ITP.

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