서준하·이상목·고영관·홍성화·오수명·윤
충
경희대학교
의과대학 외과학교실
Clinical
Review of Laparoscopic Splenectomy for Chronic Immune Thrombocytopenic Purpura
Jun
Ha Seo, Sang Mok Lee, Young Gwan Ko, Sung Wha Hong, Soo Myung Oh, Choong Yoon
Department
of Surgery, Kyung Hee University College of Medicine, Seoul, Korea
Background
: In the chronic immune thrombocytopenic purpura (ITP), the two main therapeutic
choices have been the steroid treatment and splenectomy: less than 30% of the patients
show the complete response in the steroid treatment, while splenectomy turns out
to be successful in more than 60%. Recently, the laparoscopic splenectomy is demonstrated
to be a technically feasible and safe method for the treatment of ITP. Hence the
aim of this study is to compare the clinical results reflected from the patients
with ITP who underwent the laparoscopic splenectomy with those who had the open
splenectomy.
Patients
and Methods : Results and outcomes were compared retrospectively in 37 consecutive
patients treated by the laparoscopic (n=23) or open splenectomy (n=14) from
March.1989 to September 1999.
Results
: In the patients treated by laparoscopy, 20 patients successfully underwent the
laparoscopic splenectomy and 3 patients were converted to the open splenectomy.
The operation time was significantly longer for the laparoscopic splenectomy (197.6±68.l
minutes) than for the open splenectomy (113.7±26.8 minutes)(p<0.()1). However,
the patients who underwent the laparoscopic splenectomy had a more rapid return
to diet (1.8±0.9 versus 3.5±1.2 days, p<0.01) and shorter postoperative hospital
stay (4.9±2.5 versus 11.4±3.3 days, p<0.01) than those who |
