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Factors associated with the effect of open splenectomy for immune thrombocytopenic purpura
Author(s) -
Li Ying,
Zhang Dawei,
Hua Fanli,
Gao Song,
Wu Yangjiong,
Xu Jianmin
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12783
Subject(s) - medicine , splenectomy , thrombocytopenic purpura , platelet , surgery , retrospective cohort study , thrombosis , pneumonia , gastroenterology , spleen
Objective To assess the effect and complications of open splenectomy ( OS ) for immune thrombocytopenic purpura ( ITP ) and determine preoperative factors associated with surgical effect. Methods This was a retrospective analysis of ITP patients who failed medical therapy and were treated with OS between 1997 and 2014 at the Jinshan Hospital, China. Follow‐up was 60 months. Surgical effect was determined from platelet counts and bleeding episodes. Complications were assessed including bleeding episodes. Preoperative factors were identified by logistic regression analysis. Results Fifty‐six patients (48.2 ± 16.2 yr old; 39 females) were included. Disease course was 31.2 ± 48.2 months; 91.1% patients had preoperative platelet count <20 × 10 9 /L. OS effect at 1 wk, 1 month, 1 yr, and 5 yrs was in 91.1%, 92.9%, 91.1%, and 89.3% patients, respectively. Pneumonia or lower extremity thrombosis occurred in 7.1% patients. Postoperative mild, moderate, and severe bleeding occurred in 33.9%, 50.0%, and 16.1% patients, respectively. No patients required blood transfusion. Mortality was zero. Larger spleen size associated with surgical effect at 1 wk, 1 month, and 1 yr, and lower preoperative minimum platelet count associated with effect at 5 yrs ( P < 0.05). Conclusions Open splenectomy is an effective treatment with less complications for the management of ITP . Lower preoperative minimum platelet count associated with successful OS at 5 yrs.