Laparoscopic Splenectomy for Idiopathic Thrombocytopenic Purpura, in Comparison with Open Splenectomy

Harutsugu Sodeyama, Susumu Asato, Kazuhiro Hanazaki, Masao Wakabayashi, Nobuyuki Kawamura, Tadaaki Miyazaki, Masuo Ohtsuka, Ken Hayashi*

Department of Surgery, Nagano Red Cross Hospital
Department of Surgery, Nagano Municipal Hospital*

Laparoscopic splenectomy was performed on five patients with the idiopathic thrombocytopenic purpura, and was compared with open splenectomy. During the operation, the patients were placed in a right oblique lateral and head-up position, abdominal wall-lift methods were used in addition to pneumoperitoneum, and ultrasonic dissector and Harmonic Scalpel (LCS) were useful. The operation time for laparoscopic splenectomy ranged from 164 to 298 minutes (average: 220±54 minutes), which was significantly longer than that for open splenectomy (average: 97±25 minutes). The average blood loss in laparoscopic and open splenectomy was 170±180 g (ranged from 20 to 400 g) and 204±212 g, respectively. There were no significant differences in the dose of analgesia used within three days after the operation and in the period of analgesia requirement between the two groups. Because in the patients receiving laparoscopic splenectomy, oral intake was begun 2.4±0.6 days after the operation and postoperative hospitalization was 11.4±2.1 days, the patients recovered significantly more rapidly than those who received open splenectomy. There were no fatal complications. Laparoscopic splenectomy may be the preferable treatment for the idiopathic thrombocytopenic purpura.

Key words
laparoscopic splenectomy, idiopathic thrombocytopenic purpura, harmonic scalpel

Reprint requests
Harutsugu Sodeyama Department of Surgery, Nagano Red Cross Hospital
1512-1 Wakasato, Nagano, 380 JAPAN

Accepted
January 10, 1996

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