, Volume 38, Issue 9, pp 2267-2272
Date: 11 Apr 2014

Should We Routinely Transfuse Platelet for Immune Thrombocytopenia Patients with Platelet Count Less Than 10 × 109/L Who Underwent Laparoscopic Splenectomy?

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Abstract

Background

Laparoscopic splenectomy (LS) is considered as the gold standard procedure for patients with immune thrombocytopenia (ITP). In many institutions, platelet counts less than 10 × 109/L contraindicate LS.

Objective

This study aimed to investigate the safety and feasibility of LS for ITP patients with platelet counts less than 10 × 109/L.

Methods

A total of 88 cases of LS were performed for ITP patients from June 2010 to December 2012. The patients were prospectively divided into three groups based on their immediate preoperative platelet count: < 10 × 109/L (group 1); 10 × 109/L to 30 × 109/L (group 2); and > 30 × 109/L (group 3). We collected the patients’ demographic characteristics, perioperative details, and platelet count response to surgery.

Results

The patients in the three groups had comparable demographic characteristics. Only one patient in group 1 required conversion (2.4 %). The patients in group 1 experienced more blood loss than those in group 3, but this was not statistically significant. There were no significant differences between group 2 and group 3 in terms of operating time and blood loss. No statistically significant differences were found between the three groups with regard to complications and postoperative hospital stay.

Conclusions

It is safe and feasible to perform LS in ITP patients with platelet count less than 10 × 109/L, without platelet transfusion. The indication for platelet transfusion during LS for ITP patients should be the bleeding manifestations due to thrombocytopenia other than low platelet count itself.

Xubao Liu and Bing Peng have contributed equally to this study. The abstract of this study was presented at the SAGES 2014 Annual Meeting, April 2–April 5, 2014, Salt Lake City, UT.