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KMID : 0978820010040020032
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2001 Volume.4 No. 2 p.32 ~ p.37
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Laparoscopic Splenectomy in Patients with Idiopathic Thrombocytopenic Purpura
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이병욱/Byoung Wook Lee
안승익/이건영/김세중/허윤석/최선근/홍기천/우제홍/신석환/Seung Ik Ahn/Keon Young Lee/Sei Joong Kim/Yoon Seok Hur/Sun Keun Choi/Kee Chun Hong/Ze Hong Woo/Seok Hwan Shin
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Abstract
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Purpose: To evaluate the usefulness of laparoscopic splenectomy in idiopathic thrombocytopenic purpura(ITP).
Patients and Methods: The authors reviewed 15 cases of laparoscopic splenectomy for idiopathic thrombocytopenic purpura between September 1998 and May 2001. There were 3 males and 12 females, and the mean age was 30.8 years. We used 4
ports(two
5㎜ ports, two 12㎜ ports) for all cases with modified right lateral kidney position under carbon dioxide pneumoperitoneum. The vascular control was achieved using Harmonic Scalpel, endovascular clips and EndoGIA in a few case. For the removal of
the
dissected spleen, an Endopouch was introduced into the peritoneal cavity and the spleen was placed in the bag. Piecemeal removal of splenic tissue from the bag was accomplished through the umbilical port. There was no case of conversion to open
laparotomy.
Results: The mean operation time was 225.3 min; 258min in first half and 209min in second half. The mean estimated bleeding amount was 145.5㏄. Median postoperative hospital stay was 7 days. In only one case, second operation of recurrent
ITP was
done because accessory spleen was found by postoperative spleen scan. 12 patients(80%) of complete response had been off steroids with platelet counts greater than 100,000/㎣.
Conclusion: Laparoscopic splenectomy is a relative safe and reasonable operative procedure for the patients with ITP.
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