Author/Authors :
Önder, Akın Dicle Üniversitesi - Tıp Fakültesi - Genel Cerrahi Anabilim Dalı, Turkey , Kapan, Murat Dicle Üniversitesi - Tıp Fakültesi - Genel Cerrahi Anabilim Dalı, Turkey , Gül, Mesut Dicle Üniversitesi - Tıp Fakültesi - Genel Cerrahi Anabilim Dalı, Türkiye , Aliosmanoğlu, İbrahim Dicle Üniversitesi - Tıp Fakültesi - Genel Cerrahi Anabilim Dalı, Türkiye , Arıkanoğlu, Zülfü Dicle Üniversitesi - Tıp Fakültesi - Genel Cerrahi Anabilim Dalı, Turkey , Taşkesen, Fatih Dicle Üniversitesi - Tıp Fakültesi - Genel Cerrahi Anabilim Dalı, Turkey , Taş, İlhan Dicle Üniversitesi - Tıp Fakültesi - Genel Cerrahi Anabilim Dalı, Türkiye , Ay, Enver Dicle Üniversitesi - Tıp Fakültesi - Genel Cerrahi Anabilim Dalı, Türkiye , Girgin, Sadullah Dicle Üniversitesi - Tıp Fakültesi - Genel Cerrahi Anabilim Dalı, Türkiye
Abstract :
Objectives: Splenectomy is performed in order to provide the treatment in the patients with severe idiopathic thrombocytopenic purpura, refractory to medical treatment. In this study, we aimed to investigate the postoperatif and long-term outcomes in the patients who underwent splenectomy with the diagnosis of idiopathic thrombocytopenic purpura. Materials and Methods: Between 2001-2010 at Dicle University Medical Faculty, General Surgery Department, a retrospective review of the 109 patients who had undergone splenectomy for ITP was reviewed. Age, gender, presence of accessory spleens and location, duration of the operation, number of preoperative platelet tranfusion, number of preoperative and postoperative blood transfusion, length of hospital stay, long-term outcomes, morbidity and mortality were recorded. Results: The mean age was 37.10 ± 16.62 (16-72), and there were 88 (80.7%) female and 21 (19.3%) male pa-tients. The mean operation time was 44.87 ± 10:32 (30-120) minutes. The average postoperative blood and preoperative platelet transfusion were 1.63 ± 0.85 (0-3) and 2.01 ± 0.71 (1-3) units, respectively. The accessory spleens were encountered in 20 (18.3%) patients at the ultrasonographic examination. And also the accessory spleens were encountered in 23 (21.1%) patients during operation and confirmed with histopathologic examination. The most common localization of accessory spleens were splenic hilus. The postoperative complications were occurred in 16 patients (14.7%) and the most complication was atelectasia. The mean length of hospital stay was 4:56 ± 2:45 (2-12) days. Patients were followed for an average of 28 (9-48) months. At the follow-up period, 1 (0.9 %) patient had died. Conclusion: Splenectomy can be performed safely in the treatment of the patients with idiopathic thrombocytopenic purpura unresponsive to medical treatment. Long-term good results can be obtained with splenectomy in these patients. The accessory spleens should not be overlooked to prevent recurrences.
