Effect of splenectomy on idiopathic thrombocytopenic purpura / 中国基层医药

Objective To investigate the effects of splenctomy on the idiopathic thrombocytopenic purpura (ITP) patients. Methods 9 patients with ITP were involved in the present study,who were performed with splenecto-my because of refractoriness, contraindicatiun and intolerance during corticosteroids therapy. Results The average platelet count of the patients before operation was 35×109/L,while the first,4th and 7th day after operation,the aver-age platelet count was 98×109/L, 179×109/L and 235×109/L. After follow-up for 6 months,there were 7 cases having marked improvement, and the total effective rate was 88.9%. Conclusion Splenectomy is a recommendable method for ITP, expecially for those are inefficient,incompatible and intolerated to continually pharmacotherapy.

Should Open Splenectomies Still Only be Recommended in Benign Heatologic Diseases Refractory to Medical Therapy?

PURPOSE: A laparoscopic splenectomy (LS) has been proposed as a substitute to an open splenctomy (OS) in the treatment of benign hematological diseases that are refractory to medical therapy in many centers. However, in Korea, many clinicians do not inform patients of the option of a LS in whom a splenectomy is needed. This study was undertaken to compare the safety, the outcome including the clinical benefits of a LS and an OS for a variety of benign hematological diseases. METHODS: The records of 137 patients who underwent a splenectomy (15 OS and 122 LS) at the Asan Medical Center between January 1998 and December 2002 were reviewed retrospectively. The patient demographics, surgical indications, perioperative results, morbidity, mortality and clinical outcome were evaluated. RESULTS: Open splenectomies were performed by 4 surgeons and a LS was performed by one surgeon after receiving informed consent regarding each procedure (OS & LS). Thirty eight cases (28.2%) were transfered to our department from another hospital without being given any information of LS. There was no significant difference in age, gender, ASA grading, previous abdominal surgery and comorbid diseases between the two groups. The average operating time was longer in those given a LS than OS (P0.05, 84% vs 78%, respectively) during a mean follow-up period of 38+/-12 months. CONCLUSION: LS takes longer to perform but results in minimal blood loss, less analgesics, a shorter postoperative stay and fewer complications than OS. In addition, a laparoscopic splenctomy is a safe, efficacious and a superior treatment for patients with various benign hematological disorders. Therefore, it is strongly recommended that surgeons inform patients of the option of a LS and give consideration to a transfer to other hospitals where advanced laparoscopic procedures are feasible.

Clinical Study of Partial Splenectomy in Pations Undergoing Traumatic Spleen Rupture / 中国医师杂志

Objective To summarize the experience of partial splenctomy in patients with traumatic spleen rupture.Methods Patients were assigned to spleen conservation group in which 59 patients underwent partial splenectomy,control group Ⅰ in which 60 patients underwent splenectomy and control group Ⅱ in which 60 patients underwent gastroinestinal operation. Immunologic function and filtration of red blood cell were detected in the three groups during the preoperation and the first month,the first year postoperation respectively.Results There was no significant difference between the spleen conservation group and the gastroenteric operation group.But IgM,NK-cell activity,T lymphocyte subpopulation and T lymphocyte transformation rate in the spleen conservation group were significantly higher then those in the splenectomy group (P