Seminars in Hematology
Volume 37, Issue 3 , Pages 267-274, July 2000

Laparoscopic splenectomy in chronic idiopathic thrombocytopenic purpura

  • Michael J Marcaccio

      Affiliations

    • From the Department of Surgery, McMaster University, Hamilton, Ontario, Canada
    • Hamilton Health Sciences Corp, Hamilton, Ontario, Canada
    • Corresponding Author InformationAddress reprint requests to Michael J. Marcaccio, MD, McMaster University Medical Centre, 1200 Main St W, Room 3V1, Hamilton, Ontario, Canada L8N 3Z5.

Abstract 

Splenectomy remains the definitive treatment for idiopathic thrombocytopenic purpura (ITP). Issues related to timing of splenectomy, perioperative management of platelet count, deep vein thrombosis prophylaxis, and preoperative vaccination are not standardized. Predicting the outcome of splenectomy is desirable but, again, consistent evidence for a particular approach is lacking. Laparoscopic splenectomy, first introduced in 1991, has removed some of the barriers to acceptance of splenectomy and may well change its place in the various treatment algorithms. This article reviews current knowledge with respect to laparoscopic splenectomy and provides an analysis of current evidence regarding issues of safety, efficacy, and cost effectiveness. Surgical technique is briefly reviewed. The information is drawn from a comprehensive analysis of the literature, as well as my own large experience with laparoscopic splenectomy, the majority of which has been focused on laparoscopic splenectomy for ITP.

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PII: S0037-1963(00)90105-7

Seminars in Hematology
Volume 37, Issue 3 , Pages 267-274, July 2000

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