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

ChangMoo Kang, JaeGil Lee, Sik Kim Kyung, Sub Choi Jin, Jung Lee Woo, Ro Kim Byong, Woong Ko Yoon, Sook Han Ji, Hong Min Yoo

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17 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)420-424
Number of pages5
JournalJournal of Korean Medical Science
Volume22
Issue number3
Publication statusPublished - 2007 Jul 12

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Idiopathic Thrombocytopenic Purpura
Splenectomy
Platelet Count
Morbidity
Therapeutics
Referral and Consultation
Multivariate Analysis
Steroids
Recurrence
Mortality
Infection

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kang, ChangMoo ; Lee, JaeGil ; Kyung, Sik Kim ; Jin, Sub Choi ; Woo, Jung Lee ; Byong, Ro Kim ; Yoon, Woong Ko ; Ji, Sook Han ; Yoo, Hong Min. / Long-term follow-up of laparoscopic splenectomy in patients with immune thrombocytopenic purpura. In: Journal of Korean Medical Science. 2007 ; Vol. 22, No. 3. pp. 420-424.
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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.",
author = "ChangMoo Kang and JaeGil Lee and Kyung, {Sik Kim} and Jin, {Sub Choi} and Woo, {Jung Lee} and Byong, {Ro Kim} and Yoon, {Woong Ko} and Ji, {Sook Han} and Yoo, {Hong Min}",
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Kang, C, Lee, J, Kyung, SK, Jin, SC, Woo, JL, Byong, RK, Yoon, WK, Ji, SH & Yoo, HM 2007, 'Long-term follow-up of laparoscopic splenectomy in patients with immune thrombocytopenic purpura', Journal of Korean Medical Science, vol. 22, no. 3, pp. 420-424.

Long-term follow-up of laparoscopic splenectomy in patients with immune thrombocytopenic purpura. / Kang, ChangMoo; Lee, JaeGil; Kyung, Sik Kim; Jin, Sub Choi; Woo, Jung Lee; Byong, Ro Kim; Yoon, Woong Ko; Ji, Sook Han; Yoo, Hong Min.

In: Journal of Korean Medical Science, Vol. 22, No. 3, 12.07.2007, p. 420-424.

Research output: Contribution to journalArticle

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AU - Kang, ChangMoo

AU - Lee, JaeGil

AU - Kyung, Sik Kim

AU - Jin, Sub Choi

AU - Woo, Jung Lee

AU - Byong, Ro Kim

AU - Yoon, Woong Ko

AU - Ji, Sook Han

AU - Yoo, Hong Min

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N2 - 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.

AB - 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.

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