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Long-term follow-up of laparoscopic splenectomy in patients with immune thrombocytopenic purpura

Authors
 Chang Moo Kang  ;  Jae Gil Lee  ;  Yoo Hong Min  ;  Ji Sook Han  ;  Yoon Woong Ko  ;  Byong Ro Kim  ;  Woo Jung Lee  ;  Jin Sub Choi  ;  Kyung Sik Kim 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.22(3) : 420-424, 2007 
Journal Title
 JOURNAL OF KOREAN MEDICAL SCIENCE 
ISSN
 1011-8934 
Issue Date
2007
Abstract
Laparoscopic splenectomy (LS) has been reserved for intractable and relapsing immune thrombocytopenic purpura (ITP) despite medical treatment. With further experiences of LS in ITP, we investigated long term outcomes of LS, especially newly developed morbidities, and tried to find predictive factors for favorable outcomes. From August 1994 to December 2004, fifty-nine patients whose follow-up period was more than 12 months after LS were investigated. After a long-term follow-up (median 54 months, range 12.5-129 months), a complete response (CR) was found in 28 patients (47.5%), partial response in 24 (40.7%), and no response in 7 (11.9%). The relapse rate during follow-up periods was 15.2%. The rapid response group (p=0.017), in which the platelet count increased more than twice of the preoperative platelet count within 7 days after LS, relapsing after medical treatment (p=0.02), and the satisfactory group as the initial result of LS (p=0.001) were significant for predicting CR in univariate analysis, but only the initial satisfactory group was an independent predictive factor for CR in multivariate analysis (p=0.036, relative risk=6419; 95% CI, 1.171-35.190). Infections were the most frequent morbidities during the follow-up period, which were treated well without mortality. LS is a safe and effective treatment modality for ITP. Active referral to surgery might be required, considering complications and treatment results related to long-term use of steroid-based medications.
Files in This Item:
T200700557.pdf Download
DOI
10.3346/jkms.2007.22.3.420
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Byong Ro(김병로)
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Lee, Jae Gil(이재길) ORCID logo https://orcid.org/0000-0002-1148-8035
Choi, Jin Sub(최진섭)
Hahn, Jee Sook(한지숙)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96409
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