Open versus laparoscopic splenectomy for idiopathic thrombocytopenic purpura: Clinical and economic analysis

Cordera, Fernando; Long, Kirsten Hall; Nagorney, David M.; McMurtry, Erin K.; Schleck, Cathy D.; Ilstrup, Duane M.; Donohue, John H.

doi:10.1067/msy.2003.204

Cited by 96 publications

(73 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Postoperative bleeding and pulmonary complications constituted the majority of severe complications, whereas incision complications were the most common minor complications. The proposed increased cost of LS (42,43) does not seem to be confirmed by recent studies (13), probably because the cost of laparoscopic equipment is balanced out by the shorter postoperative hospital stay.…”

Section: Critical Evaluationmentioning

confidence: 75%

See 1 more Smart Citation

Laparoscopic Splenectomy for Benign Hematological Disorders in Adults: A Systematic Review

Moris

Dimitriou

Grınıatsos

2017

View full text Add to dashboard Cite

Section: Critical Evaluationmentioning

confidence: 75%

“…Finally, the higher cost of LS compared to OS could be considered as a relative contraindication for LS (42,43). However, a recent report disclosed that the hospital cost for LS was similar to the cost of OS (2607±68.78 US$ for LS vs. 2601±60.13 US$ for OS) (13).…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Splenectomy for Benign Hematological Disorders in Adults: A Systematic Review

Moris

Dimitriou

Grınıatsos

2017

View full text Add to dashboard Cite

“…İTP'li hastalarda splenektomi sonrası sintigrafi ile tespit edilen geride kalan dalak dokusu (aksesuar dalak) oranı %12-48 arasında değişmektedir (12,22,23). Bizim serimizde 4 (%11) hastada aksesuar dalak saptandı.…”

Section: Gereç Ve Yöntemlerunclassified

“…(12,13). Damashek ve arkadaşları (14) hipersplenizm tanımı yaparak, steroid uygulaması ile trombosit düzeylerinde artışı göstermişlerdir (12,14). Bu tarihten sonra medikal tedavi İTP tedavisinde birincil yaklaşım haline gelmiştir (12).…”

Section: Introductionunclassified

“…Damashek ve arkadaşları (14) hipersplenizm tanımı yaparak, steroid uygulaması ile trombosit düzeylerinde artışı göstermişlerdir (12,14). Bu tarihten sonra medikal tedavi İTP tedavisinde birincil yaklaşım haline gelmiştir (12). Kortikosteroidler ile birincil medikal tedaviye yanıtsızlık ya da güvenli trombosit seviyesini sürdürmek için devamlı tedavi ihtiyacı olması durumlarında splenektomi ikincil olarak düşünülmelidir (1,3,10,11).…”

Section: Introductionunclassified

See 1 more Smart Citation

Recurrence in immune thrombocytopenic purpura after splenectomy

Tan¹,

Görgün²,

Karaca³

et al. 2012

Gaziantep Med J

View full text Add to dashboard Cite

ÖzetÇalışmamızda, immun trombositopenik purpura nedeniyle splenektomi yapılan hastalarda, yineleme oranı ve buna etki eden nedenleri değerlendirip sonuçları literatür eşliğinde tartışmayı amaçladık. İmmun trombositopenik purpura nedeni ile splenektomi yapılan 36 hasta çalışma kapsamına alındı. Hastalar yaş ve cinsiyet yönünden değerlendirildi. Takipli olan 25 hasta ortalama 24 ay izlendi. Yineleme oranı ve buna etki edebilecek nedenler olarak ameliyatın açık veya kapalı olması, cinsiyet, yaş, ameliyat öncesi ve sonrası 2. gün trombosit değerleri değerlendirilerek literatür eşliğinde tartışıldı. On üç hasta (%36,1) erkek, 23 hasta (% 63,9) hasta kadın idi. Ortalama yaş 37,7 idi. Aksesuar dalak 4 hastada (%11,1) bulundu. İzlenen 25 hastanın, 5'inde (%20) yineleme, 1'inde (%4) ise parsiyel yineleme saptandı. Kadınlarda ve 40 yaş üzerindekilerde yineleme oranı fazla olsa da istatistiksel olarak anlamlı değildi. Ameliyat sonrası 2. gün alınan trombosit değeri 156000/ml altında olanlarda, bu değerin üstünde olanlara göre yineleme oranı fazla ve istatistiksel olarak anlamlı idi (p=0,024). İmmun trombositopenik purpura cerrahi tedavisinde yinelemeyi tamamen önlemek en iyi şartlarda dahi mümkün olamamaktadır. Bu nedenle ameliyat sonrası 2. gün alınan trombosit değerleri ile yineleme olabilecek hastaları saptayıp daha sık kontrol altında tutmanın yerinde olacağını düşünmekteyiz. Anahtar kelimeler: İmmun trombositopenik purpura; nüks; splenektomi; yineleme AbstractIn our study, we aimed to evaluate and discuss the recurrence rate and the causes for recurrences in splenectomy due to immune thrombocytopenic purpura. Thirty-six patients who had splenectomy due to immune thrombocytopenic purpura, enrolled in the study. Patients were evaluated for age and gender. Twenty-five patients were followed at a mean of 24 months. Recurrence rate and causes for recurrences; laparoscopic or open surgery, gender, age, preoperative and postoperative 2nd day platelet count were evaluated and discussed with the data in the literature. Thirteen patients (36.1%) were male and 23 patients (63.9%) patients were female. Mean age was 37,7. Accessory spleen was found in 4 patients (11.1%). In the follow-up of 25 patients, 5 patients (20%) had recurrence, 1 patient (4%) had partial recurrence. Although the recurrence rate was higher in woman and over 40 year old group, this was not statistically significant. The recurrence rate of patients, whose platelet count below 156.000/ml in postoperatively 2nd day, was significantly more than the patients whose platelet count above this value (p=0,024). Even under the best conditions, it is not possible to completely avoid the recurrences in surgical treatment of immune thrombocytopenic purpura. Therefore, we think it would be helpful to identify the patients with postoperatively 2nd day platelet count who have possibility for recurrence and keep those under control more often.

show abstract

Splenectomy for immune thrombocytopenic purpura: Surgery for the 21st century

2007

View full text Add to dashboard Cite

Although immune thrombocytopenic purpura (ITP) is the most common autoimmune hematological disorder, there is still controversy regarding the optimal management of this condition. Medical therapy may cure a proportion of patients with ITP but there are still a significant number of these individuals who are at risk for bleeding events. Surgery has become the least popular therapeutic option for ITP as other medical therapies have become available that attempt to avoid splenectomy and its morbidity. However, the clinical response to these therapies has not been overwhelming based on the fairly small number of trials conducted to date. With current minimally invasive surgical techniques, splenectomy should be again regarded as a viable therapeutic option in patients with ITP. The laparoscopic approach avoids much of the morbidity and complications seen with the conventional open surgical approach and studies have demonstrated similar, if not better, outcomes. In addition, the risk of infection following splenectomy is not as high as may be suspected, particularly with current vaccination regiments. It should be a priority for both the hematology and medical community to advocate for clinical trials to rationally study alternatives to splenectomy. In the interim, laparoscopic splenectomy should be considered as an additional front line therapeutic option in ITP patients. Am. J. Hematol. 83:93-96, 2008. V

show abstract

Open versus laparoscopic splenectomy for idiopathic thrombocytopenic purpura: Clinical and economic analysis

Cited by 96 publications

References 36 publications

Laparoscopic Splenectomy for Benign Hematological Disorders in Adults: A Systematic Review

Laparoscopic Splenectomy for Benign Hematological Disorders in Adults: A Systematic Review

Recurrence in immune thrombocytopenic purpura after splenectomy

Splenectomy for immune thrombocytopenic purpura: Surgery for the 21st century

Contact Info

Product

Resources

About