Laparoscopic splenectomy and the treatment outcomes for idiopathic thrombocytopaenic purpura at North Shore Hospital

Aim Firstly, the demographics of laparoscopic splenectomy cases at North Shore Hospital (Takapuna, Auckland, New Zealand), the outcomes of operative technique, and perioperative complications by a single surgeon were reviewed. Secondly, analysis was performed on patients with idiopathic thrombocytopaenic purpura (ITP) with regard to platelet response and detection of preoperative predictors. Methods Laparoscopic splenectomy patients from 1998 to 2007 were reviewed with respect to demographics, operation and their complications. ITP outcomes, analysed separately, were categorised as complete remission for postsplenectomy platelet counts greater than 150×109/L, partial remission as 30–149×109/L and refractory as platelet counts less than 30×109/L. The relationships between preoperative steroid, immunoglobulin transfusion and operative outcomes were analysed. Results 29 (67%) out of 43 laparoscopic splenectomies were for ITP. For ITP cases, 19 (65%) achieved complete remission and six (21%) partial remission at 3-month follow-up. Follow-up detected that two cases in each group had relapses after