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Abstract
LAPAROSCOPIC SPLENECTOMY FOR PATIENTS WITH IMMUNE THROMBOCYTOPENIA
*Dr. Monier T. Ahmed Altaee, Dr. Hayder Nooruldeen Hayder and Dr. Adil K. Sallom
ABSTRACT
Background: Laparoscopic splenectomy (LS) is the one of the most important second-line treatment for patients with Idiopathic thrombocytopenic purpura (ITP) who do not respond to corticosteroids. Aims: To identify risk factors associated with persistence thrombocytopenia after LS for ITP patients and to investigate the short complications associated with LS. Method: This is a single center prospective study including a total of 40 patients with ITP who undergo LS. Patients were followed up for 30 days after operation. Data regarding the presence of complication (bleeding, hematoma, abscess, atelectasis, pneumonia and others) were recorded. Furthermore, a blood sample was collected from each patient was collected and the platelet count was calculated. The primary end point of the study is the success or failure of LS in treatment of ITP. Results: 31 patients (77.5%) had complete response (increase in platelet count >100000 above baseline value), 6 (15%) had response, and 3 (7.5%) had no reaction. 11 (27.5%) encountered complications. No patient had several problems. Abscess and atelectasis were the most prevalent consequences. Two patients (5%), pneumonia, haemorrhage, and hematoma, and one patient (2.5%), had portal site infection. Female gender, comorbidities, and complications substantially predicted non-complete response. Conclusion: Refractory ITP patients may safely have laparoscopic splenectomy independent of preoperative PLT. The treatment does not cause blood loss or conversion. Iraqi ITP receiving LS had severe postoperative complications. Female gender, comorbidities, and complications may raise LS failure rates.
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