Late Results After Splenectomy in Adult Idiopathic

Background: We performed a retrospective study on patients with idiopathic thrombocytopenic purpura (ITP) to evaluate the response to splenectomy in relation to preoperative platelet count. Materials and Methods: Two groups of patients oper-ated on with laparoscopic or open splenectomy for ITP, with a platelet count 30,000/L (study group: 22 pa-tients) and 30,000/L (control group: 18 patients), re-spectively, were compared. The two groups were homo-geneous in relation to age, sex, length of preoperative steroid therapy, and time interval between diagnosis and surgery (Student t test with P .1). The results of surgery were evaluated at one year after splenectomy. Positive response to surgery, according to the American Society of Hematologic Guidelines, was considered in patients with a postoperative platelet count 100,000/L or in patients with a postoperative platelet count 30,000/L and a twofold increase in platelet count from baseline, in the absence of bleeding. The postoperative platelet count increase rate was statis-tically related to preoperative platelet count in both the study and control groups. Statistical analysis was per-formed using the Student’s t test for independent sample and the Pearson correlation in a 2-tailed test. Results: No relationship between preoperative platelet count and postoperative platelet percent increase was observed in the control group (r –0.41; P .089), whereas a significant negative correlation (r –0.68; P .0004) was found in the study group. Conclusions: A higher increase of postoperative percent platelet count may be predicted in patients with a low preoperative platelet count