| Revista: | Revista do Colegio Brasileiro de Cirurgioes |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000283409 |
| ISSN: | 0100-6991 |
| Autors: | Zorron, Ricardo1 Cunha Neto, Silvio Henriques da2 Kanaan, Eduardo3 Toaspern, Tatiana Vista Chaves, Leandro Prado Madureira-Filho, Delta |
| Institucions: | 1Universidade Federal do Rio de Janeiro, Hospital Universitario Clementino Fraga Filho, Rio de Janeiro. Brasil 2Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Cirurgia, Rio de Janeiro. Brasil 3Hospital Municipal Lourenco Jorge, Servico de Cirurgia, Rio de Janeiro. Brasil |
| Any: | 2004 |
| Període: | Jul-Ago |
| Volum: | 31 |
| Número: | 4 |
| Paginació: | 265-270 |
| País: | Brasil |
| Idioma: | Portugués |
| Tipo de documento: | Artículo |
| Enfoque: | Caso clínico, analítico |
| Resumen en inglés | BACKGROUND: Immune thrombocytopenic purpura (ITP) is a common indication for splenectomy. In order to evaluate the results of Laparoscopic Splenectomy, 17 patients with ITP were submitted to this procedure in a prospective study. METHODS: Using three trocars through a posterior approach and simple inabsorbable ligatures, without using hemoclips and vascular stapplers, splenectomy was carried out in a prospective series of 17 patients. RESULTS: All patients were successfully managed laparoscopically, with no conversion to open surgery. Complications ocurred in three patients: one wound haematoma, one residual splenic tissue requiring reoperation, and one pancreatic pseudocyst that was treated by conservative measures. An additional fourth trocar was needed in four patients. Mean operative time was 132.9min, mean postoperative stay was 2.53 days. Intraoperative platelet transfusion was needed in two patients (11.8%) and accessory spleen was detected in four (23.5%). Favourable sustained response to splenectomy was obtained in 13 patients (76.5%), with partial or no response in four (23.5%). CONCLUSION: Careful anatomical dissection technique and search for accessory tissue is needed to avoid splenosis and therapy failure. Detection of accessory spleens by this method is precise and reliable. Patients with PTI have the same remission rates of open surgery, with less complications and shortened postoperative stay. The results suggest that Laparoscopic Splenectomy is effective and safe, and has become the golden standard for the treatment of ITP with surgical indication |
| Resumen en portugués | Os resultados obtidos sugerem que a esplenectomia laparoscópica é segura e efetiva, tornando-se o tratamento de escolha para PTI com indicação cirúrgica |
| Disciplines | Medicina |
| Paraules clau: | Cirugía, Gastroenterología, Inmunología, Esplenectomía, Bazo, Púrpura trombocitopénica, Esplenomegalia, Laparoscopia, Esplenosis |
| Keyword: | Medicine, Gastroenterology, Surgery, Splenectomy, Spleen, Thrombocytopenic purpura, Splenomegaly, Laparoscopy, Splenosis, Immunology |
| Text complet: | Texto completo (Ver PDF) |
