Kim Dong Jin, Chung Jae Hee
Department of Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2014 Jun;86(6):314-8. doi: 10.4174/astr.2014.86.6.314. Epub 2014 May 23.
Laparoscopic splenectomy (LS) for pediatric chronic immune thrombocytopenic purpura (ITP) patients has recently become widespread. However, its long-term result is rarely reported in children.
We retrospectively analyzed the patients who underwent LS for pediatric chronic ITP from June 1998 to April 2007.
There were 18 patients (14 male and 4 female) with mean age 9.5 ± 3.8 years. 14 complete response, 3 partial response, and 1 no response were occurred. During the 82-month median follow-up period, 9 patients maintained in a remission state without any additional treatment, and 9 patients relapsed. In a comparative analysis of the relapse group and no relapse group, hospital stays were longer in the relapse group and the preoperative platelet counts and platelet counts at 1 month post were lower in relapse group. A relapse-free survival among 17 patients who achieved partial or complete responses following LS showed 76.5%, 61.8%, and 33.0% at 1-, 5-, and 10-year following LS, respectively.
Although LS in pediatric chronic ITP patients had excellent results immediately after surgery, careful follow up is needed due to late relapse even when a complete response has been noted for several years.
腹腔镜脾切除术（LS）治疗小儿慢性免疫性血小板减少性紫癜（ITP）患者近来已广泛应用。然而，其在儿童中的长期结果鲜有报道。
我们回顾性分析了1998年6月至2007年4月期间接受LS治疗小儿慢性ITP的患者。
共有18例患者（男14例，女4例），平均年龄9.5±3.8岁。出现14例完全缓解、3例部分缓解和1例无反应。在82个月的中位随访期内，9例患者无需任何额外治疗维持缓解状态，9例患者复发。在复发组和未复发组的对比分析中，复发组住院时间更长，复发组术前血小板计数及术后1个月血小板计数更低。17例LS术后获得部分或完全缓解的患者，其无复发生存率在LS术后1年、5年和10年分别为76.5%、61.8%和33.0%。
尽管小儿慢性ITP患者行LS术后即刻效果良好，但即使已观察到数年的完全缓解，仍需密切随访以防晚期复发。
