Abstract

Objective: Immune (idiopathic) thrombocytopenic purpura (ITP) is an acquired autoimmune disease characterized with reduced thrombocyte count due to antithrombocyte factors. The treatment has medical and surgical options. In this study, the results of surgical treatment (splenectomy) for ITP were evaluated.

Materials and Methods: The patients with ITP who had applied in the last 10 years were retrospectively reviewed. Data collection included demographic features, platelet levels, preoperative treatment, operation procedure and follow-up period.

Results: There were 52 patients (16 male and 41 female) with a mean age of 52 years (range: 20-82 yrs). The mean duration of symptoms was 47.34 months (range:1–480 months). The mean level of platelet was 76.269x10³/mm³ in the preoperative period. Forty patients were performed open splenectomy, whereas 17 underwent laparoscopic splenectomy. Nine of them (15%) had an accessory spleen and one patient had recurrence secondary to overlooked accessory spleen. In the postoperative period, platelet levels ranged between 4-798x10³/mm³ and only five patients (8, 7%) had platelet count rate of less than 30.000/mm³. Six patients (10%) had complications in the early postoperative period, and three patients were referred to hematology clinic because of early relapse.

Conclusion: The need for splenectomy in the patients with ITP has been decreased due to advances in medical treatment. Nevertheless, in case of failure in medical management, we suggest that laparoscopic or open splenectomy be performed with low morbidity and mortality, providing long-term control in platelet dysfunction.