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Long-term results of laparoscopic splenectomy for immune thrombocytopenia

Kazuhiro Tada, Masayuki Ohta, Kunihiro Saga, Hiroomi Takayama, Teijiro Hirashita, Yuichi Endo, Hiroki Uchida, Yukio Iwashita, Masafumi Inomata. Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine

Purpose: Laparoscopic splenectomy (LS) has been recognized as the standard therapy for patients with medically refractory immune thrombocytopenia (ITP). The short-term results after LS have been reported, however the long-term results of LS remain unknown. The aim of this study was to evaluate the short- and long-term results in patients underwent LS.

Methods: From May 1993 to August 2017, twenty-three patients who underwent LS for refractory ITP in our institute were retrospectively reviewed. Laparoscopic surgical procedure was standard with using laparoscopic linear stapler. Responses to surgery were evaluated a month after the operation based upon the American Society of Hematology 2011 evidence-based practice guidelines for ITP.

Results: There was no open conversion in this study. The mean operation time and blood loss were 151 min and 64 g, respectively. There was no case using blood transfusion during and after operation. With regard to complications, one patient (4%) had a postoperative pancreatic fistula that did not require percutaneous drainage. Positive responses, including the complete and partial remissions, were achieved in 78% (18/23). The mean follow-up duration was 89 months, and the 5-, 10-, and 15-year relapse-free survival rates were 94% for all three time points.

Conclusions: The present study demonstrated that LS for ITP can provide good long-term outcomes.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 85619

Program Number: P745

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

34

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