• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Perioperative Platelet Transfusion Is Not Necessary in Laparoscopic Splenectomy for Patients of Immune Thrombocytopenia with Extremely Low Platelet Count

Xiaodong Chen, MD PhD, Bing Peng, PhD MD Prof, Jin Zhou, MD, Yunqiang Cai, MD, Yichao Wang, MD, Zhong Wu, MD. Sichuan University West China Hospital

Objective: Laparoscopic splenectomy (LS) has been adopted as the standard technique for splenectomy in patients with immune thrombocytopenia (ITP). However, the safe level of platelet count (PC) and the necessity for platelet transfusion during LS still remain controversial. This study was aim at evaluating the feasibility, safety and efficacy of LS for ITP patients who had extremely low platelet count (<10×109/L) without perioperative platelet transfusion.
Methods: From 2005 to 2010, 69 patients with ITP underwent LS in our department. Of these patients, six cases (group Ia) with PC <10×109/L were administered platelet transfusion during LS, whereas another 16 cases (group Ib) of this condition, together with 22 cases (group II) with PC =10-30×109/L and 25 cases (group III) with PC >30×109/L, received no platelet transfusion. Recently, we carried out comparisons between groups in terms of demographic data and perioperative outcome. Comparisons of dichotomous variables were carried out using Fisher’s exact tests; continuous variables were evaluated using one-way ANOVA analysis. The correlation between platelet count, operative time and blood loss was tested by means of bivariate correlations. Logistic regression model was used to determine the best predictive variables for RBC transfusions. Statistical analysis was performed using the SPSS for Windows, version 16.0.
Results: LS was completed in 67 patients. Five patients (7.2%) experienced massive bleeding (>400ml) during surgery mainly from splenic capsular tears or venous branches near the hilum, of whom two patients (2.9%) needed conversion to open surgery. No postoperative bleeding was observed. Ten complications occurred in eight patients (11.6%).The operative time, conversion and complication rates were similar among groups. In general, patients with PC <10×109/L had a significantly lower preoperative hemoglobin concentration (p =0.035), suffered relatively more intraoperative blood loss (p =0.612) and postoperative drainage exudate (p =0.061), received more packed RBC transfusions (p =0.068) than patients with PC =10-30 or >30 ×109/L. However, blood loss was not correlated with the level of PC (p =0.116), but determined by operative time (r =0.636, p <0.001); and RBC transfusion was significantly predetermined by lower preoperative hemoglobin (OR =23, p <0.001).

Perioperative outcome
group Ia group Ib group II group III p value Overall
Preop PC, ×109/L 4.5±3.4 5.4±2.2 17.8±6.0 56.3±23.8 <0.001 27.7±26.6
Preop HGB, g/L 113±22 110±26 127±22 129±19 0.035 123±23
Operative time, min 167±48 176±42 170±58 145±46 0.205 162±50
Blood loss, ml 117±108 118±156 100±94 71±113 0.612 95±118
Drainage exudate, ml 147±161 135±126 94±97 57±59 0.061 95±104
Massive bleeding, n 0 2 2 1 0.762 5
RBC transfusion, n 1 6 2 2 0.068 11
Conversions, n 0 1 1 0 0.602 2
Complications, n 0 0 5 3 0.146 8
Hospital stay, d 7.2±1.5 7.4±2.4 7.6±2.2 8.0±4.2 0.920 7.6±3.0

Conclusions: ITP patients with PC <10×109/L could be splenectomized safely and successfully without platelet transfusion. Therefore, we recommended that perioperative platelet transfusion might be not necessary in LS for patients of this condition.


Session: Poster
Program Number: P502
View Poster

2,118

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2011 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons