Ann Surg Treat Res.  2014 Jun;86(6):314-318. 10.4174/astr.2014.86.6.314.

Long-term results of laparoscopic splenectomy in pediatric chronic immune thrombocytopenic purpura

• Kim DJ
• Chung JH

• KMID: 2167109
• DOI: http://doi.org/10.4174/astr.2014.86.6.314

Abstract

PURPOSE
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.
METHODS
We retrospectively analyzed the patients who underwent LS for pediatric chronic ITP from June 1998 to April 2007.
RESULTS
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.
CONCLUSION
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.

Keyword

Idiopathic thrombocytopenic purpura; Laparoscopy; Splenectomy

MeSH Terms

Child
Follow-Up Studies
Humans
Laparoscopy
Length of Stay
Male
Platelet Count
Purpura, Thrombocytopenic, Idiopathic*
Recurrence
Retrospective Studies
Splenectomy*

Figure

• 

  Fig. 1 Relapse-free survival of 17 pediatric chronic immune thrombocytopenic purpura patients who achieved complete response following laparoscopic splenectomy.

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