The feasibility of laparoscopic splenectomy for ITP patients without preoperative platelet transfusion.

BACKGROUND/AIMS: The aim of this study was to investigate the feasibility and safety of laparoscopic splenectomy for idiopathic thrombocytopenic purpura patients without platelet transfusion before surgery.

METHODOLOGY: From 2004 to 2010, laparoscopic splenectomy was performed in 30 patients with ITP (idiopathic thrombocytopenic purpura, ITP) in our department and clinical information was recorded. Inclusion criteria is patient with a preoperative platelet count of <20x109/L. All of the 30 patients retrospectively reviewed were divided into 2 groups, according to whether they received platelet transfusion preoperatively or not. Perioperative data were analyzed.

RESULTS

The clinical efficacy of treatment was significant (obvious response rates of the two cohorts were 17/19 and 9/10). There was no significant difference in the surgical procedure or postoperative efficacy of laparoscopic splenectomy for ITP patients, regardless of whether there was preoperative platelet transfusion, including operating time, ratio of intraoperative blood transfusion, estimated blood loss, the rate of conversion, postoperative platelet counts, amount of postoperative drainage and postoperative hospital stay.

CONCLUSIONS

Laparoscopic splenectomy without platelet transfusion can be a feasible and safe procedure in patients with a platelet count lower than 20x109/L, with a normal prothrombin time and without any preoperative bleeding tendency or severe coagulopathy.