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Open Medicine

formerly Central European Journal of Medicine

Editor-in-Chief: Darzynkiewicz, Zbigniew

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IMPACT FACTOR 2016 (Open Medicine): 0.294
IMPACT FACTOR 2016 (Central European Journal of Medicine): 0.116

CiteScore 2016: 0.28

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Source Normalized Impact per Paper (SNIP) 2015: 0.154

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Volume 6, Issue 1


Prognostic factors for positive immune thrombocytopenic purpura outcome after laparoscopic splenectomy

Mindaugas Kiudelis / Antanas Mickevicius / Ruta Dambrauskiene / Rolandas Gerbutavicius / Rasa Griniūtė / Dalia Adukauskiene
Published Online: 2010-12-16 | DOI: https://doi.org/10.2478/s11536-010-0063-0


Laparoscopic splenectomy is considered as a second step treatment for ITP patients. The purpose of this study was to determine efficiency of laparoscopic splenectomy for ITP patients and to identify the independent prognostic factors that may predict the positive outcome. Two hundred and thirty nine patient medical records were analyzed retrospectively. The special questionnaire, which included present platelet count, the steroid usage and its dosage, was sent to all patients. The complete response (CR) was defined, when the platelet count was above 130 × 109 /L. The 239 adult patients with a median age of 51.3 (16–93 years) were included in this cohort. The median follow up period was 75 months. 49 patients, who relapsed after steroid treatment, underwent laparoscopic splenectomy. The short term postoperative CR was 71.4% after laparoscopic splenectomy compared to 38.1% in non-splenectomized patients (p < 0.000). The long term CR was 79.5 % in patients after splenectomy compared to 47.4% in non-splenectomized patients (p < 0.018). After univaried analysis three clinical variables were found to be significantly related to splenectomy outcome: disease duration (p<0.007), preoperative platelet count (p<0.049) and platelet count on the third postoperative day (p<0.000). Multiple logistic regression analysis demonstrated, that only platelet count on the 3rd postoperative day > 129 × 109 /L; RR=53.3 95% (CI, 1.888–1517.98) was significant predictor for long-term positive ITP outcome after laparoscopic splenectomy. Splenectomy is effective treatment for ITP. Platelet count > 129 × 109/L on the third postoperative day is the significant predictor of positive long-term outcome after laparoscopic splenectomy.

Keywords: Licorice; Laparoscopic splenectomy; ITP; platelet count

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About the article

Published Online: 2010-12-16

Published in Print: 2011-02-01

Citation Information: Open Medicine, Volume 6, Issue 1, Pages 123–130, ISSN (Online) 2391-5463, DOI: https://doi.org/10.2478/s11536-010-0063-0.

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© 2010 Versita Warsaw. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. BY-NC-ND 3.0

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