Laparoscopic splenectomy for immune thrombocytopenia in patients with a very low platelet count
| Autor: | Piotr Major, Piotr Małczak, Jan Witowski, Michał Pędziwiatr, Jan Kulawik, Andrzej Budzyński, Marcin Strzałka, Anna Lasek, Dorota Radkowiak, Anna Zychowicz |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Low platelet count Urology medicine.medical_treatment Splenectomy laparoscopy Laparoscopic splenectomy splenectomy 03 medical and health sciences 0302 clinical medicine medicine In patient Laparoscopy Original Paper medicine.diagnostic_test business.industry Gastroenterology Obstetrics and Gynecology Perioperative Immune thrombocytopenia Surgery immune thrombocytopenia 030220 oncology & carcinogenesis Perioperative care 030211 gastroenterology & hepatology business |
| Zdroj: | Videosurgery and other Miniinvasive Techniques |
| Popis: | Introduction Laparoscopic splenectomy (LS) is the gold standard in treating immune thrombocytopenia (ITP). However, there are still some problems in decision-making when considering LS in patients with a very low platelet count (PLT). Aim To evaluate safety outcomes of LS in patients with severe ITP and very low PLT in comparison to those with higher PLT. Material and methods We retrospectively analyzed consecutive patients who underwent LS in a single institution between April 1998 and December 2017. Perioperative care was based on an algorithm developed at our department which takes into consideration the patient’s PLT level. Patients were divided into 2 groups depending on the PLT level (cut-off point 50,000/mm3). Results The mean operative time in the low PLT group and high PLT group was 90 ±42.1 min and 95 ±45 min, respectively (p = 0.59). Intraoperative blood loss was 144 ±226.1 ml in the low PLT group and 83 ±161.24 ml in the high PLT group (p = 0.23). Complications occurred in 5 (9.09%) patients in the low PLT group and 16 (11.51%) in the high PLT group (p = 0.67). There were no conversions in the group with lower PLT, while 2 patients in the group with higher PLT had to be converted to open surgery (p = 0.38). Patients with low PLT preoperatively more often required perioperative platelet transfusions (13 vs. 1, p < 0.001). Conclusions Laparoscopic splenectomy is safe and feasible treatment in patients with ITP regardless of the PLT level. Still, patients with critical ITP and marginally low PLT require special awareness. |
| Databáze: | OpenAIRE |
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