Predictive factors associated with long-term effects of laparoscopic splenectomy for chronic immune thrombocytopenia

Abstract

The purpose of this study was to investigate the long-term effects of laparoscopic splenectomy (LS) for patients with chronic immune thrombocytopenia (ITP), and to identify predictive factors for promising hematological outcomes. We retrospectively analyzed the clinical records and follow-up data in patients who underwent LS for chronic ITP from November 2005 to August 2012. The related parameters were assessed by univariate and multivariate logistic regression analyses. The curve of life table was drawn to clarify the long-term response rate. Of the 92 included patients, 49 (53.3 %) patients achieved a complete response, 21 patients (22.8 %) a partial response, and the remaining 22 (23.9 %) showed no response to LS. Eleven patients relapsed within 1 year after LS, especially within 3 months (n = 7), while three patients relapsed 17, 26, and 28 months after LS, respectively. Long-term specific complications after LS were not observed. Platelet counts on postoperative month 3 (POM 3) is a significant independent predictor of long-term favorable hematological outcomes (P < 0.001). Based on our study, we conclude that LS is associated with promising long-term response for patients with chronic ITP, and platelet counts on POM 3 could be used as a predictor of long-term hematological outcome.