Laparoscopic versus open splenectomy for immune thrombocytopenic purpura.
Am J Surg
; 176(4): 366-9, 1998 Oct.
Article
en En
| MEDLINE
| ID: mdl-9817257
BACKGROUND: Laparoscopic splenectomy (LS) has been proposed as a substitute to open splenectomy (OS) in the treatment of immune thrombocytopenic purpura (ITP). The aim of this study was to compare two cohorts of patients with ITP who underwent OS or LS. PATIENTS AND METHODS: From February 1990 to January 1997, 27 patients underwent OS and 22 LS. Perioperative characteristics, outcomes, and complications were comparatively analyzed. RESULTS: Mean age was 38 years (+/- 16) in the OS group, and 39 (+/- 16) in the LS group; the male: female ratio was 1:2 in both groups. Median preoperative platelet count was 16 x 10(9)/L (range 2 to 186 x 10(9)/L) in the OS group, and 50 x 10(9)/L (2 to 241 x 10(9)/L) in the LS group. Mean operative time was 2.7 hours (+/- 0.7) for OS, and 4.5 hours (+/- 1) for LS (P <0.0001). Two conversions to laparotomy occurred in the LS group. A total of 14 complications occurred in 10 patients of the OS group; 8 complications occurred in 6 patients of the LS group. Two patients died in the OS group and 1 in the LS group. Mean postoperative discharge was 6 days (3 to 44) in the OS group and 4 days (2 to 11) in the LS group (P <0.02). Response rates were similar in both groups. CONCLUSIONS: Laparoscopic splenectomy is comparable to OS in terms of efficacy and safety, and it is associated with a shorter hospital stay.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Púrpura Trombocitopénica
/
Esplenectomía
/
Laparoscopía
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Am J Surg
Año:
1998
Tipo del documento:
Article
Pais de publicación:
Estados Unidos