Hamdy, A., Labib, M., Gomaa, A. (2019). Evaluation of Laparoscopic Splenectomy in Idiopathic Thrombocytopenic Purpura. The Egyptian Journal of Hospital Medicine, 74(6), 1406-1415. doi: 10.21608/ejhm.2019.26979
Al Sayed Ahmed Hamdy; Mohamed Fathi Labib; Ahmed Talaat Gomaa. "Evaluation of Laparoscopic Splenectomy in Idiopathic Thrombocytopenic Purpura". The Egyptian Journal of Hospital Medicine, 74, 6, 2019, 1406-1415. doi: 10.21608/ejhm.2019.26979
Hamdy, A., Labib, M., Gomaa, A. (2019). 'Evaluation of Laparoscopic Splenectomy in Idiopathic Thrombocytopenic Purpura', The Egyptian Journal of Hospital Medicine, 74(6), pp. 1406-1415. doi: 10.21608/ejhm.2019.26979
Hamdy, A., Labib, M., Gomaa, A. Evaluation of Laparoscopic Splenectomy in Idiopathic Thrombocytopenic Purpura. The Egyptian Journal of Hospital Medicine, 2019; 74(6): 1406-1415. doi: 10.21608/ejhm.2019.26979
Evaluation of Laparoscopic Splenectomy in Idiopathic Thrombocytopenic Purpura
Departments of General Surgery, Faculty of Medicine, Al-Azhar University
Abstract
Background: primary ITP was defined according to the American Society of Hematology 2011 evidence-based practice guideline as a platelet count less than 100 × 109 /L without other causes or disorders that may be associated with thrombocytopenia. The main first-line therapy for ITP is oral corticosteroids. Splenectomy is generally considered a second-line therapy in patients who are refractory to steroids and in those who relapse after an initial response to medical therapy. Objective: the aim of this study was to evaluate the feasibility, safety and efficacy of LS in ITP patients. Patients and Methods: this study was carried out on 20 patients diagnose as having ITP and indicated for splenectomy, 60% were females and 40% were males. Their age ranged from 17-33 years with a mean of 24.3± 5.39 years. Results: the platelet count raised from (30000 to 140000/L) pre-operative to (90000 to 190000/ L) post-operative. There was statistically significance difference between pre and post-operative platelet count (p <0.001). From the assessment of platelet count according to American Society of Hematology 2011 evidence-based practice guidelines for ITP. Nineteen patients (95%) achieved complete response, while only one patient (5%) achieved partial response. Conclusion: it was concluded that LS produces an adequate postoperative rise in platelet count and it is associated with less operating time, post-operative hospital stay, blood loss and postoperative complications.