A Long-term Follow-Up Study Of Patients With Immume Thrombocytopenic Purpura After Laparoscopic Splenectomy

ObjectiveTo follow up the long-term outcomes and identify the predict factors of patients with immune thrombocytopenic purpura (ITP) after treat with laproscopic splenectomy (LS).MethodsWe retrospectively analyze the data of 84 ITP patients who underwent LS at our hospital from Jan 2007 to Jan 2014.ResultsPostoperative follow-up range 12 to 96 months with a mean of 51 months and complication rate was 8%. There was no overwhelming postsplenectomy infection (OPS I) and death case. The overall response rate (complete response [CR] and partial response [PR]) was 75% (63/84), the no response rate was 25% (21/84). No-relapse survival analyses were performed using Kaplan-Meier method, the 1-,3-,5-and 7-year remission rate was 82.1%,77.2%,72.1% and 67.5%, respectively. Between the response group (CR and PR) and non-response group, univariate analysis showed statistical significances among age, response to steroid, preoperative platelet count and postplenectomy platelet count peak within 1 week (P< 0.5), but not for gender, course of disease, duration of operation, intraoperative bleeding volume (P> 0.5); in mulvariate analysis, only postsplenectomy platelet count peak within 1 week was an independent factor to predict therapeutic effect of patients with ITP to LS (P=0.001, OR=1.008,95%CI=1.004-1.013).ConclusionLS is a safe and feasible treatment to therapy ITP and the long-term response rate is high. Postsplenectomy platelet count peak within 1 week may be the predict factor of patients with ITP to LS.