Objectives: Laparoscopic splenectomy has been increasinglyused in patients with idiopathic thrombocytopenic purpura.Because it is associated with minimal abdominaltrauma, platelet consumption could be reduced with thelaparoscopic approach. The aim of this study was to analyzeintraoperative bleeding and the need for apheresis platelets,comparing laparoscopic with open splenectomy.Methods: Records of 40 patients who underwent splenectomy(20 through laparoscopy and 20 through opensurgery) for idiopathic thrombocytopenic purpura wereretrospectively reviewed. Intraoperative bleeding andneed of perioperative apheresis platelets were evaluatedin both groups. Statistical evaluation was conducted usingthe Mann-Whitney rank test, and differences were consideredsignificant at P0.01.Results: The mean amount of intraoperative bleeding wasless in the laparoscopic group (P0.01). Apheresis plateletswere necessary in all patients in the open group (2units transfused in 55% and 1 unit in 45% of cases) andonly in 30% of cases in the laparoscopic group (1 unittransfused in each case).Conclusions: Laparoscopic splenectomy is a safe procedurealso in patients at high risk for bleeding diathesis. Inidiopathic thrombocytopenic purpura, laparoscopic splenectomyshould be the gold-standard surgical treatment.Need of platelet transfusion is probably reduced whenlaparoscopic splenectomy is compared with open surgeryin these patients.
|Titolo:||Laparascopic splenectomy reduces the need for platelet tranfusion in patients with idiopathic thrombocytopenic purpura|
|Data di pubblicazione:||2005|
|Appare nelle tipologie:||1.1 Articolo in rivista|