Bresler Laurent, Guerci Agnes, Brunaud Laurent, Ayav Ahmet, Sebbag Hugues, Tortuyaux Jean-Michel, Lederlin Pierre, Boissel Patrick
Department of Surgery C, Hopital de Brabois, 54511 Vandoeuvre, France.
World J Surg. 2002 Jan;26(1):111-4. doi: 10.1007/s00268-001-0190-5. Epub 2001 Nov 26.
The technical feasibility of laparoscopic splenectomy (LS) has been recently established. However, data regarding the efficacy of the procedure with long-term follow-up of patients with idiopathic thrombocytopenic purpura (ITP) are scarce. The objective of this study was to determine retrospectively the immediate efficacy and the long-term results of a standardized laparoscopic procedure applied to patients with ITP refractory to medical treatment. Laparoscopic splenectomy was performed in 35 patients for ITP between May 1993 and May 1998. The lateral approach was used in the last 27 patients. Data were recorded retrospectively on that group. Twenty-six patients (96%) underwent successful LS. Mean operative time for the laparoscopic procedure was 90 minutes. There were no postoperative deaths. Postoperative complications developed in three patients. Thrombocytopenia resolved after surgery in 93% of patients, but 7 patients (25%) experienced relapse during a mean 28-month follow-up. At present no patient needs medical therapy to maintain a normal platelet count. Laparoscopic splenectomy is feasible and safe in patients with ITP. Long-term results of LS for ITP are comparable to those achieved with open splenectomy.
腹腔镜脾切除术（LS）的技术可行性最近已得到证实。然而，关于特发性血小板减少性紫癜（ITP）患者长期随访的该手术疗效的数据却很匮乏。本研究的目的是回顾性地确定应用于难治性ITP患者的标准化腹腔镜手术的近期疗效和长期结果。1993年5月至1998年5月期间，对35例ITP患者实施了腹腔镜脾切除术。最后27例患者采用侧入路。对该组患者的数据进行了回顾性记录。26例患者（96%）成功接受了LS。腹腔镜手术的平均手术时间为90分钟。无术后死亡病例。3例患者出现术后并发症。93%的患者术后血小板减少症得到缓解，但7例患者（25%）在平均28个月的随访期间复发。目前没有患者需要药物治疗来维持正常血小板计数。腹腔镜脾切除术对ITP患者是可行且安全的。LS治疗ITP的长期结果与开放性脾切除术相当。
