Open Versus Laparoscopic Splenectomy for Immune Thrombocytopenic Purpura

Han, Sang Moon; Kim, Won Woo; Kim, Eung Kook

Abstract

BACKGROUND: To determine the advantage of laparoscopic splenectomy techniques in immune thrombocytopenic purpura (ITP), we compared it with an open splenectomy.
METHODS
The cases of all patients who had undergone (52) a splenectomy for ITP at St. Mary's Hospital from January 1993 to December 1997 were reviewed. From the 52 cases, 21 cases were managed with a laparoscopic technique only and 31 cases were managed with an open technique.
RESULTS
Blood and platelet transfusion requirements were reduced in the laparoscopic group. Although the mean operating time was slightly longer in the laparoscopic group (110 versus 184 minutes, p<0.001), the mean hospital stay (9.7 versus 5.9 days, p<0.001) was slightly shorter and the postoperative analgesic requirement (p<0.001) and the incidence of post operative complications (9.5 versus 48.4%) were greatly reduced. The detection rates of accessory spleens was low in the laparoscopic group.
CONCLUSIONS
The laparoscopic splenectomy produced better clinical outcomes than an elective splenectomy for ITP. Also, such laparoscopic methods reduced costs.