Abstract:Objective:To evaluate the therapeutic efficacy of laparoscopic splenectomy (LS) for patients with idiopathic thrombocytopenic purpura (ITP) and to investigate the change of parameters of platelets.
Methods :Twenty-one patients with ITP after LS were studied, including the following paramenters: the operation time, intraoperative blood loss and postoperative complications, and compared perioperative platelet count(PC), packed platelet volume(PPV), mean platelet volume(MPV), and platelet distribution width (PDW) with the postoperative results.
Results:The mean operation time was 1.5 h. Intraoperative mean blood loss was 60 mL, postoperative hospitalization time was 5 d and with no case of delayed healing of incision. Accessory spleen was found in 19 % of patients . The incidence of complication was 4.8 %, and with no deaths. Platelet count and packed platelet volume increased with fluctuation, but mean platelet volume and platelet distribution width decreased with fluctuation. The parameters were in multipoint dynamic equilibrium with fluctuation and coordinated restoration. All patients were followed-up. No case had recurrence at 1.5~5.5 y, and platelet-associated antibody was in normal range. Bone marrow examination was normal.
Conclusions:The treatment of ITP with LS is safe and effective. The selection of therapeutic plan should depend on the changes of platelet parameters.