scholarly journals Long-Term Outcomes of Laparoscopic Splenectomy Versus Open Splenectomy for Idiopathic Thrombocytopenic Purpura

2014 ◽  
Vol 99 (3) ◽  
pp. 286-290 ◽  
Author(s):  
Yikun Qu ◽  
Jian Xu ◽  
Chengbin Jiao ◽  
Zhuoxin Cheng ◽  
Shiyan Ren
Keyword(s):  
Idiopathic Thrombocytopenic Purpura ◽  
Laparoscopic Splenectomy ◽  
Operation Time ◽  
Long Term Outcomes ◽  
Thrombocytopenic Purpura ◽  
Long Term Outcome ◽  
Open Splenectomy ◽  
Drain Removal ◽  
Significant Difference

Abstract The long-term outcomes of laparoscopic splenectomy (LS) versus open splenectomy (OS) in patients with idiopathic thrombocytopenic purpura (ITP) are not known. A retrospective analysis of 73 patients who underwent splenectomy (32 LS and 41 OS) for refractory ITP between April 2003 and June 2012 was conducted. LS was associated with shorter hospital stay (P = 0.01), less blood loss and blood transfusion during surgery, quicker resumption of oral diet (P < 0.0001), and earlier drain removal (P < 0.01). Conversion to OS was required in 4 patients (12.5%). Operation time was significantly longer in LS (P < 0.0001). Deep venous thrombosis (DVT) was observed in 1 patient after LS and in 4 patients after OS (P = 0.52). One patient died from intraperitoneal bleeding after OS, another patient developed pulmonary embolism. Median follow-up of 36 months was performed in LS group (29 of 32, 91%) and of 46 months in OS group (35 of 41, 85%), 25 patients (86%) in LS group and 32 (91%) in OS group reached sustained complete response (P = 0.792). Kaplan-Meier analysis showed that there was no significant difference in the relapse-free survival rate between the groups (P = 0.777). In conclusion, the long-term outcome of laparoscopic splenectomy is not different from that of open splenectomy for patients with ITP.

Laparoscopic Splenectomy for Idiopathic Thrombocytopenic Purpura: Outcome and Long-term Results

2001 ◽  
Vol 26 (1) ◽  
pp. 111-114 ◽  
Author(s):  
Laurent Bresler, M.D. ◽  
Agnes Guerci, M.D. ◽  
Laurent Brunaud, M.D. ◽  
Ahmet Ayav, M.D. ◽  
Hugues Sebbag, M.D. ◽  
...  
Keyword(s):  
Idiopathic Thrombocytopenic Purpura ◽  
Laparoscopic Splenectomy ◽  
Long Term Results ◽  
Thrombocytopenic Purpura

scholarly journals Long-term outcomes of combined chemotherapy in chronic refractory idiopathic thrombocytopenic purpura

2007 ◽  
Vol 120 (18) ◽  
pp. 1643-1646 ◽  
Author(s):  
Jie TAO ◽  
Ying HUANG ◽  
Hong-qiang LI ◽  
Ting-ting WANG ◽  
Xiao-yan WANG ◽  
...  
Keyword(s):  
Idiopathic Thrombocytopenic Purpura ◽  
Combined Chemotherapy ◽  
Long Term Outcomes ◽  
Thrombocytopenic Purpura

scholarly journals Effect of High Body Mass Index on Short- and Long-term Outcomes of Patients who Underwent Laparoscopic Gastrectomy for Advanced Gastric Cancer: A Case Control Study

2020 ◽  
Author(s):  
Tianqi Luo ◽  
Guoming Chen ◽  
Chengcai Liang ◽  
Kaiming Jiang ◽  
Kai Lei ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Body Mass Index ◽  
Operation Time ◽  
High Body Mass Index ◽  
Long Term Outcomes ◽  
Intraoperative Bleeding ◽  
Significant Difference ◽  
Short And Long Term ◽  
High Bmi

Abstract Background High body mass index (BMI) is thought to be a preoperative risk factor for surgical treatment. Until now, few studies have investigated the long-term impact of preoperative high BMI on advanced gastric cancer (GC) patients who underwent laparoscopic gastrectomy (LG). Therefore, the present study was designed to compare clinical outcomes between high BMI and normal BMI patients who underwent LG. MethodsWe retrospectively investigated 282 pathological stage II~III GC cases who underwent radical LG plus D2 lymphadenectomy from February 2009 to May 2018. Based on the China BMI classification, the patients were classified into a high (BMI ≥ 24 kg/m2) or normal (BMI < 24 kg/m2) BMI group. The clinical characteristics, intraoperative findings, short-term and long-term outcomes of the two groups of patients were then compared. Results The high BMI group had longer operation time (160.1 ± 36.0 minutes vs. 147.7 ± 33.7 minutes; P = 0.005) and greater intraoperative bleeding (138.3 ± 239.4ml vs. 86.6 ± 67.7ml; P = 0.002) compared to the normal BMI group. Moreover, shorter time to flatus, starting the soft diet, removing drain tube and length of stay (all P < 0.05) were observed in the high BMI patients. However, there was no significant difference in relapse-free survival or overall survival between the two groups. Conclusion Patients with high BMI was associated with longer operation time and greater amount of intraoperative bleeding but had faster recovery as compared to those with normal BMI. Also, LG can be considered as safe with no significant difference in terms of short- and long-term outcomes on the peri- and post-operative outcomes between the two BMI groups of patients. Nevertheless, these surgeries for high BMI patients should be performed by experienced surgeons.

scholarly journals Therapy with high-dose dexamethasone (HD-DXM) in previously untreated patients affected by idiopathic thrombocytopenic purpura: a GIMEMA experience

Blood ◽  
2006 ◽  
Vol 109 (4) ◽  
pp. 1401-1407 ◽  
Author(s):  
Maria Gabriella Mazzucconi ◽  
Paola Fazi ◽  
Sayla Bernasconi ◽  
Giulio De Rossi ◽  
Giuseppe Leone ◽  
...  
Keyword(s):  
Median Time ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Response Rate ◽  
High Dose ◽  
First Line ◽  
Thrombocytopenic Purpura ◽  
Pilot Studies ◽  
High Dose Dexamethasone ◽  
Significant Difference

Abstract In idiopathic thrombocytopenic purpura (ITP), corticosteroids have been widely recognized as the most appropriate first-line treatment, even if the best therapeutic approach is still a matter of debate. Recently, a single high-dose dexamethasone (HD-DXM) course was administered as first-line therapy in adult patients with ITP. In this paper we show the results of 2 prospective pilot studies (monocentric and multicentric, respectively) concerning the use of repeated pulses of HD-DXM in untreated ITP patients. In the monocenter study, 37 patients with severe ITP, age at least 20 years and no more than 65 years, were enrolled. HD-DXM was given in 4-day pulses every 28 days, for 6 cycles. Response rate was 89.2%; relapse-free survival (RFS) was 90% at 15 months; long-term responses, lasting for a median time of 26 months (range 6-77 months) were 25 of 37 (67.6%). In the multicenter study, 95 patients with severe ITP, age at least 2 years and no more than 70 years, were enrolled. HD-DXM was given in 4-day pulses every 14 days, for 4 cycles; 90 patients completed 4 cycles. Response rate (85.6%) was similar in patients classified by age (< 18 years, 36 of 42 = 85.7%; ≥ 18 years, 41 of 48 = 85.4%, P = not significant), with a statistically significant difference between the second and third cycle (75.8% vs 89%, P = .018). RFS at 15 months 81%; long-term responses, lasting for a median time of 8 months (range 4-24 months) were 67 of 90 (74.4%). In both studies, therapy was well tolerated. A schedule of 3 cycles of HD-DXM pulses will be compared with standard prednisone therapy (eg, 1 mg/kg per day) in the next randomized Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA) trial.

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