Abstract
Background
Laparoscopic splenectomy has become the preferred surgical procedure for the management
of idiopathic thrombocytopenic purpura (ITP). However, there studies have directly
compared the incidence of recurrent ITP secondary to missed accessory spleens in open
versus laparoscopic splenectomy.
Methods
Open and laparoscopic splenectomies performed for ITP at 4 sites over 18 years were
analyzed. The incidence of recurrent disease secondary to missed accessory spleens
was compared between the open and laparoscopic splenectomy groups.
Results
A total of 105 splenectomies (54 open/51 laparoscopic) were performed. Accessory spleens
were identified in 6 laparoscopic and 6 open cases (P = .57). Recurrent disease occurred in 27.6% of open and 14.6% of laparoscopic cases
(P = .222). There were no cases of recurrent ITP secondary to a missed accessory spleen
in either group.
Conclusions
The incidence of missed accessory spleens causing recurrent disease is similar when
splenectomy is performed either open or laparoscopically.
Keywords
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References
- Recurrence of immunologic thrombocytopenic purpura due to hypertrophy of retained accessory spleens.Acta Chir Iugosl. 2002; 49: 41-43
- Role of Doppler sonography in the evaluation of accessory spleens after splenectomy.J Ultrasound Med. 2001; 20: 1347-1351
- Accessory spleens: preoperative diagnostics limitations and operational strategy in laparoscopic approach to splenectomy in idiopathic thrombocytopenic purpura patients.Langenbecks Arch Surg. 2005; 390: 47-51
- Laparoscopic splenectomy for idiopathic thrombocytopenic purpura.Am J Surg. 2004; 187: 720-723
- Accessory spleens—diagnostic and therapeutic problem of the laparoscopic splenectomy in idiopathic thrombocytopenic purpura patients.Zentralbl Chir. 2004; 129: 114-118
- Laparoscopic treatment of accessory splenic tissue.Surg Laparosc Endosc. 1996; 6: 330-331
- Laparoscopic removal of accessory spleens after splenectomy for relapsing autoimmune thrombocytopenic purpura.Eur J Surg. 1999; 165: 1199-1200
- Intraoperative scintigraphic localization and laparoscopic excision of accessory splenic tissue.Surg Endosc. 1998; 12: 159-161
- Laparoscopic accessory splenectomy for recurrent idiopathic thrombocytopenic purpura and hemolytic anemia.Surg Endosc. 2000; 14: 761-763
- Splenectomy for primary and recurrent immune thrombocytopenic purpura—current criteria for patient selection and results.Ann Surg. 1987; 206: 529-551
- Accessory splenectomy in recurrent chronic immune thrombocytopenic purpura.Am J Hematol. 1992; 41: 184-189
- Accessory splenectomy in management of recurrent idiopathic thrombocytopenic purpura.Mayo Clinic Proc. 1978; 53: 442-446
- Accessory spleen compromising response to splenectomy for idiopathic thrombocytopenic purpura.Radiology. 1985; 155: 793-796
- Residual splenic function after laparoscopic splenectomy: a clinical concern.Arch Surg. 1998; 133: 56-60
- Idiopathic thrombocytopenic purpura: detection of accessory splenic tissue.Clin Nucl Med. 1981; 6: 141-145
- Inadequate detection of accessory spleens and splenosis with laparoscopic splenectomy.Surg Endosc. 1998; 12: 101-106
- Laparoscopic splenectomy for idiopathic thrombocytopenic purpura (ITP).Surg Endosc. 2003; 17: 95-98
- Laparoscopic splenectomy for idiopathic thrombocytopenic purpura.Surg Laparosc Endosc Percutan Tech. 2002; 12: 412-419
- Outcome of laparoscopic splenectomy based on hematologic indication.Surg Endosc. 2002; 16: 272-279
- Laparoscopic splenectomy: lessons from the learning curve.Can J Surg. 1998; 41: 28-36
- Open versus laparoscopic splenectomy for idiopathic thrombocytopenic purpura: clinical and economic analysis.Surgery. 2003; 134: 45-52
Article info
Publication history
Received in revised form:
February 5,
2007
Received:
December 6,
2006
Identification
Copyright
© 2007 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
