Is laparoscopic splenectomy safe in patients with immune thrombocytopenic purpura and very low platelet count: A single-institution experience

Nihat Aksakal, MD, Umut Barbaros, MD, Orhan Agcaoglu, MD, Mustafa Tukenmez, MD, Berkay Kilic, MD, Omer Cucuk, MD, Ridvan Seven, MD, Ahmet Dinccag, MD, Selcuk Mercan, MD. Istanbul School of Medicine

Purpose: Minimal invasive procedures has become increasingly popular during the last decades. The aim of thisretrospective study was to evaluate the safety and feasibility of laparoscopic splenectomy in patients with immune thrombocytopenic purpura who has very low platelet counts. 

Methods: Between March 28, 2005 and June 08, 2013, a total of 132 patients with the diagnosis of immune thrombocytopenic purpura were included to study. The patients who underwent laparoscopic splenectomy were alienated into two groups according to their platelet counts lower than 10000 (group 1) and higher than 10000 (group 2)

Results: There were 16 patients in group 1 with very low platelet counts, and 116 in group 2.  One patient in group 1 had converted to laparotomy due to peroperative bleeding, and there were 5 conversion to open in group 2.  There were also 2 patients in group 2 who underwent laparatomy on post operative day 1 due to delayed intra-abdominal bleeding. Moreover, one patient in each group had pancreatic fistula.

Conclusions: Laparoscopic splenectomy is a safe technique in patients with ITP even the patients have very low platelet counts.

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