LAPAROSCOPIC SPLENECTOMY OFFERS ADVANTAGES IN SELECTED PATIENTS WITH IMMUNE THROMBOCYTOPENIC PURPURA

被引：42

作者：

SCHLINKERT, RT ^{[1
]}

MANN, D ^{[1
]}

机构：

[1] SCOTTSDALE MEM HOSP N,SCOTTSDALE,AZ

来源：

AMERICAN JOURNAL OF SURGERY | 1995年 / 170卷 / 06期

关键词：

D O I：

10.1016/S0002-9610(99)80029-4

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: Splenectomy plays a crucial role in the management of selected patients with immune thrombocytopenic purpura (ITP). Laparoscopic splenectomy has been suggested as an alternative to open techniques. MATERIALS AND METHODS: A retrospective chart review was made for all patients undergoing splenectomy for ITP at our institution from June 1987 to August 1994. RESULTS: Twenty-one patients underwent splenectomy for ITP. Fourteen open procedures (group 1) and 7 laparoscopic procedures (group 2) were performed. Eleven of 14 patients in group 1 and all 7 patients in group 2 had appropriate increases in platelet count following surgery. There were 3 complications in group 1 and no major complications in group 2. Operative time was longer in group 2 (154 versus 68 minutes, P <0.05), but decreased with experience (210 to 135 minutes), Compared with patients in group 1, patients in group 2 tolerated liquids sooner (0.7 versus 2.6 days, P <0.05), required less parenteral narcotic (14 versus 65 morphine equivalents, P <0.05), and were discharged sooner (2.1 versus 5 days, P <0.05). All patients in group 2 remain well and require no medication after a mean follow-up of 11 months. CONCLUSIONS: Laparoscopic splenectomy is safe and effective in the management of select patients with ITP and offers advantages over open techniques.

引用

页码：624 / 627

页数：4

共 14 条

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