Montalvo Jorge, Velazquez David, Pantoja Juan P, Sierra Mauricio, López-Karpovitch Xavier, Herrera Miguel F
1 Department of Surgery, "Salvador Zubirán" National Institute of Medical Sciences and Nutrition , Mexico City, Mexico .
J Laparoendosc Adv Surg Tech A. 2014 Jul;24(7):466-70. doi: 10.1089/lap.2013.0267. Epub 2014 Jun 6.
Laparoscopic splenectomy (LS) is considered the standard treatment for patients with refractory primary immune thrombocytopenia (ITP).
All patients with ITP who underwent LS during the last 17 years and who had a minimum follow-up of 1 year were included. Several perioperative variables such as age, platelet count, and duration of preoperative therapy were recorded and analyzed, looking for potential predictive variables of clinical response.
In total, 150 patients were included: 108 (72%) women and 42 (28%) men, with a mean age of 37.3±15.8 years. In the evaluation 1 year after surgery, 133 (88.7%) patients had achieved complete response, 4 (2.7%) had a response, and in 13 (8.6%) there was no response. None of the analyzed preoperative variables was identified as a predictive factor of response at 1 year. Immediate responders after surgery (≥150,000 platelets/mL during the first week) had a higher platelet count and rate of complete response at 1 year (94.2%).
LS has a high success rate in patients with refractory ITP. Potential predictive indicators of success remain to be determined.
腹腔镜脾切除术（LS）被认为是难治性原发性免疫性血小板减少症（ITP）患者的标准治疗方法。
纳入过去17年中接受LS且至少随访1年的所有ITP患者。记录并分析了一些围手术期变量，如年龄、血小板计数和术前治疗持续时间，以寻找临床反应的潜在预测变量。
共纳入150例患者：108例（72%）为女性，42例（28%）为男性，平均年龄为37.3±15.8岁。在术后1年的评估中，133例（88.7%）患者达到完全缓解，4例（2.7%）有反应，13例（8.6%）无反应。分析的术前变量均未被确定为1年时反应的预测因素。术后即刻反应者（第一周血小板计数≥150,000/毫升）1年时血小板计数和完全缓解率更高（94.2%）。
LS治疗难治性ITP患者成功率高。成功的潜在预测指标仍有待确定。
