Amaral J F, Meltzer R C, Crowley J P
Department of Surgery, Brown University and Rhode Island Hospital, Providence, U.S.A.
Surg Laparosc Endosc. 1997 Aug;7(4):340-4.
This report describes the use of laparoscopic accessory splenectomy in treating recurrent idiopathic thrombocytopenic purpura (ITP). The patient presented 36 months after initial splenectomy with a platelet count of 16,000 cells/microl and nontolerance of medical therapy. A technetium-99 labeled, heat-damaged red blood cell scan revealed two small foci in the upper left quadrant. This finding was confirmed by an abdominal computed tomography scan. After laparoscopic accessory splenectomy, the patient was discharged (23 h after surgery) and at 9 months showed a platelet count of 234,000 cells/microl with no medical therapy. A minimally invasive approach to accessory spleen removal can be beneficial to patients with recurrent ITP and documented accessory splenic tissue.
本报告描述了腹腔镜辅助脾切除术在治疗复发性特发性血小板减少性紫癜（ITP）中的应用。该患者在初次脾切除术后36个月出现血小板计数为16,000个/微升，且不耐受药物治疗。锝-99标记的热损伤红细胞扫描显示左上象限有两个小病灶。腹部计算机断层扫描证实了这一发现。腹腔镜辅助脾切除术后，患者（术后23小时）出院，9个月时血小板计数为234,000个/微升，未接受药物治疗。对于复发性ITP且有记录的副脾组织的患者，采用微创方法切除副脾可能有益。
