Efficacy and feasibility of laparoscopic splenectomy in patients with a low platelet count / 中华肝胆外科杂志

ABSTRACT

Objective To investigate the feasibility and efficacy of laparoscopic splenectomy (LS) in patients with a low platelet count.Methods To retrospectively analyse the database of 76 ITP patients operated from 2010 to 2014.A low platelet count was defined as a platelet count of less than-30 × 109/L.The patients were divided into three groupsA (0～ 10 × 109/L),B (10～30 × 109/L),C (＞30 × 109/L) based on preoperative platelet counts.The surgical outcomes and hematological outcomes were compared among the three groups after LS.Results The operations on the 76 patients were all successfully carried out.The mean operating time of group A was (198.9 ± 46.2) min,and it was significantly longer when compared with group B (135.6 ±24.1) min and group C (125.4 ±30.0) min (P ＜0.05).The mean intraoperative blood loss of group A was (182.9 ±37.3) ml,which was significantly more when compared with group B (104.1 ±21.4) ml and group C (102.1 ±43.6) ml,(P ＜0.05).There were no significant difference among the three groups in postoperative complication rate and length of postoperative hospital stay,(P ＞ 0.05).All patients were followed up at 2,6 and 12 months after the operation and the hematological outcomes were measured.The successful therapeutic rates after LS in group A was 42.9％,and it was significantly worse when compared with group C (75％) (P ＞0.05);there was no significant difference when compared with group B (64.7％),(P ＜ 0.05).Conclusion Low preoperative platelet counts have an impact on the efficacy and postoperative recovery after laparoscopic splenectomy.LS was safe and feasible for [TP patients with low preoperative platelet counts.