Long-term results of laparoscopic splenectomy in pediatric chronic immune thrombocytopenic purpura

Abstract

Purpose: Laparoscopic splenectomy (LS) for pediatric chronic immune thrombocytopenic purpura (ITP) patients has recently become widespread. However, its long-term result is rarely reported in children.

Methods: We retrospectively analyzed the patients who underwent LS for pediatric chronic ITP from June 1998 to April 2007.

Results: There were 18 patients (14 male and 4 female) with mean age 9.5 ± 3.8 years. 14 complete response, 3 partial response, and 1 no response were occurred. During the 82-month median follow-up period, 9 patients maintained in a remission state without any additional treatment, and 9 patients relapsed. In a comparative analysis of the relapse group and no relapse group, hospital stays were longer in the relapse group and the preoperative platelet counts and platelet counts at 1 month post were lower in relapse group. A relapse-free survival among 17 patients who achieved partial or complete responses following LS showed 76.5%, 61.8%, and 33.0% at 1-, 5-, and 10-year following LS, respectively.

Conclusion: Although LS in pediatric chronic ITP patients had excellent results immediately after surgery, careful follow up is needed due to late relapse even when a complete response has been noted for several years.

Keywords: Idiopathic thrombocytopenic purpura; Laparoscopy; Splenectomy.

Fig. 1

Relapse-free survival of 17 pediatric chronic immune thrombocytopenic purpura patients who achieved complete response following laparoscopic splenectomy.