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Comparative Study on Laparoscopic Splenectomy and Open Splenectomy for the Treatment of Idiopathic Thrombocytopenic Purpura

Author: ZhangWei
Tutor: WangGuangYi
School: Jilin University
Course: Clinical
Keywords: Laparoscopic Splenectomy Idiopathic thrombocytopenic purpura
CLC: R657.63
Type: Master's thesis
Year: 2007
Downloads: 76
Quote: 0
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Abstract


The condition of many patients with blood diseases after repeated hormone , traditional Chinese medicine , gammaglobulin treatment repeated or no improvement , then splenectomy is the only effective way , and therefore has a trauma , less pain, less bleeding , rapid postoperative recovery , fewer complications , shorter hospital stay , the wound is small but beautiful laparoscopic splenectomy is the best choice for patients . Objective To compare laparoscopic splenectomy (laparoscopic splenectomy, LS) and laparotomy (open splenectomy, OS) splenectomy treatment of idiopathic thrombocytopenic purpura (idiopathic thrombocytopenic purpura, ITP) safety, effectiveness and superiority . Methods A retrospective analysis and follow-up of General Surgery, First Hospital of Jilin University, January 2006 - January idiopathic thrombocytopenic purpura patients seven cases of laparoscopic splenectomy and six cases of open splenectomy surgery method and a therapeutic effect. The results of the treatment efficiency of LS group was 85.7 % , the OS group was 83.3% ( χ2 = 0.014 , P gt ; 0.05) . LS group and OS operation time was (87.1 ± 21.4) min and ( 90.8 ± 25.8 ) min ( t = 0.283, P = 0.783 ) ; blood loss (85.7 ± 58.3) ml (176.7 ± 65.9 ) ml, (t = 2.642, P = 0.023); postoperative hospital stay (7.86 ± 1.35) d and ( 14.17 ± 7.28) d ( t = 2.265 , P = 0.045 ) ; the postoperative feeding time ( 1.14 ± 0.38) d ( 2.33 ± 0.52 ) d ( t = 4.795 , P = 0.001 ) ; postoperative ambulation were (1.29 ± 0.49) d and ( 2.17 ± 0.41 ) d ( t = 3.492 , P = 0.005 ) ; two groups of hospital costs (16800.0 ± 4567.2) and $ (21878.3 ± 3003.5) ( t = 2.320 , P = 0.041 ) rather LS postoperative complication rate is lower than the OS group ; LS group surgery after the pain than the OS group slightly ; conclusions the LS treatment of ITP efficacy and OS similar , are effective therapy for the treatment of refractory ITP , treatment efficiency and surgical approach is independent of the choice ; 2, LS also has the security of the group 7 of laparoscopic splenectomy surgery , the surgery went smoothly , no case of side injury , and no one laparotomy ; 3, LS compared with OS compared with trauma , less pain, less blood loss , rapid postoperative recovery , fewer complications , shorter hospital stay , low cost , small but beautiful wound superiority . LS can replace the OS to refractory ITP effective treatment .

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CLC: > Medicine, health > Surgery > Of surgery > Abdominal surgery > Spleen > The hypersplenism disease surgical treatment
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