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Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia

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Abstract

Purpose

Splenectomy is the standard therapy for medically refractory immune thrombocytopenia (ITP). Laparoscopic splenectomy (LS) has gained wide acceptance; however, the long-term outcomes of LS versus open splenectomy (OS) for patients with ITP remain unclear.

Methods

We analyzed, retrospectively, 32 patients who underwent splenectomy, as LS in 22 and OS in 10, for refractory ITP at our institute. Data were evaluated based on the American Society of Hematology 2011 evidence-based practice guidelines for ITP.

Results

Although the operation time was significantly longer in the LS group (p < 0.01), LS was associated with less blood loss (p < 0.01), infrequent blood transfusion during surgery (p < 0.01), quicker resumption of oral intake (p < 0.01), and shorter hospital stay (p < 0.01) than OS. Positive responses, including complete and partial remission, were achieved in 90% of the OS group patients and 77% of the LS group patients. The mean follow-up periods were 183 and 92 months, respectively. Relapse-free survival rates, 15 years after the operation were 63% in the OS group and 94% in the LS group.

Conclusions

LS can provide better short-term results and comparable long-term results to those of OS for ITP.

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Authors and Affiliations

  1. Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Oita, 879-5593, Japan

    Kazuhiro Tada, Masayuki Ohta, Kunihiro Saga, Hiroomi Takayama, Teijiro Hirashita, Yuichi Endo, Hiroki Uchida, Yukio Iwashita & Masafumi Inomata

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  1. Kazuhiro Tada
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  2. Masayuki Ohta
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Correspondence to Kazuhiro Tada.

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Tada, K., Ohta, M., Saga, K. et al. Long-term outcomes of laparoscopic versus open splenectomy for immune thrombocytopenia. Surg Today 48, 180–185 (2018). https://doi.org/10.1007/s00595-017-1570-2

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