Outcomes of Laparoscopic Splenectomy for Idiopathic Thrombocytopenic Purpura: A Comparative Study with Open Splenectomy

Hiromitsu Jinno, Osamu Itano, Hiroshi Yagi, Naoyuki Kobayashi, Fumio Suzuki, Hitoshi Ohtaka and Hiroshi Murakami^*

Department of Surgery, Department of Internal Medicine^* Tachikawa Hospital

Laparoscopic splenectomy (LS) is being accepted as an effective alternative to open splenectomy (OS) in treating idiopathic thrombocytopenic purpura (ITP). The objective of our retrospective study is to compare the outcome of LS and OS and to evaluate their safety and efficacy. We compared 14 LS patients who underwent treatment from February 1998 to April 2001 to a control group of 7 patients who underwent OS. All LSs were successful. The mean operative time was 185 minutes (range: 143-260) for LS and 116 minutes (range: 78-140) for OS (p<0.01) with a similar amount of blood loss of 87.7ml for LS and 101.7ml for OS. Postoperative use of analgesics was lower for LS patients (p<0.01), and LS patients tolerated oral intake and mobilization earlier than OS patients (p<0.01). The median length of postoperative stay was10.9days for LS and 15.7 days for OS (p<0.01). Complications occurred in 14% of LS patients and 28% of OS patients. Compared to OS, LS requires more operative time but is associated with less pain, a more rapid return of gastrointestinal function, and a shorter hospital stay. With respect to ITP treatment, LS appears to be an effective alternative to OS.

Key words
laparoscopic splenectomy, idiopathic thrombocytopenic purpura

Reprint requests
Hiromitsu Jinno Department of Surgery, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 JAPAN

Accepted
October 31, 2001

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