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

研究成果: Contribution to journalReview article査読

45 被引用数 (Scopus)

抄録

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.

本文言語英語
ページ(範囲)129-135
ページ数7
ジャーナルSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
6
2
DOI
出版ステータス出版済み - 1996

All Science Journal Classification (ASJC) codes

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