Impact of hematological diagnosis on early and late outcome after laparoscopic splenectomyrid=""

Abstract

LS is a safe and reproducible procedure for most hematological indications, with a similar immediate outcome for benign diseases and a long-term hematological response comparable to the standard results that have been observed in open series.

Postsplenectomy recurrence of idiopathic thrombocitopenic purpura: role of laparoscopic splenectomy in the treatment of accessory spleen

“…Lack of immediate and satisfactory post-splenectomy result or recurrence of thrombocytopenia are almost entirely connected with the remaining splenic tissue (7)(8)(9)(10)(11)(12)(13). Most authors, despite the use of different imaging techniques (ultrasonography, US; classic and spiral Computed Tomography, CT; and scintigraphy) underline the lack of reliable ways of preoperative assessment of ectopic splenic tissue (9, 10, 14, 15).…”

“…Targarona et al (20) reported the findings of an accessory spleen in 33% of the patient who had not clinical improvement after laparoscopic splenectomy for treatment of ITP. An association between the presence of missed accessory splenic tissue and recurrent or unresolved ITP after initial splenectomy has been reported (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Accessory spleens: preoperative diagnostics limitations and operational strategy in laparoscopic approach to splenectomy in idiopathic thrombocytopenic purpura patients

“…Idiopathic thrombocytopenic purpura is the most frequent indication for elective splenectomy [1,2,3,13,15,16,17]. The pathophysiology of the disease is associated with excessive destruction of the platelets within the spleen, liver or outside those organs, with the co-activity of antiplatelet antibodies [18,19].…”

Laparoscopic surgery of the spleen: state of the art

“…Laparoscopic splenectomy (LS), however, first documented in a canine model and later performed successfully in humans by Delaitre (in Paris) [6], Carrol (in Los Angeles) [7], and Poulin (in Montreal) [8], is much less invasive, requiring three or four incisions of 2-10 mm. While several authors have reported success in performing LS in adults [9, 10,11,12,13,14,15,16,17,18,19,20,21,22,23] and in children [24,25,26,27,28], very few have exceeded 100 cases (Table 1) [9, 10,11,12,13,14,15,16,17,18,19,20,21,22,23]. Still, in these series LS has been consistently shown to be a safe and feasible procedure.…”