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RESULTS AND PREDICTIVE FACTORS FOR SUCCESSFUL SINGLE INCISION LAPAROSCOPIC SPLENECTOMY IN CHILDREN WITH IMMUNE THROMBOCYTOPENIC PURPURA
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Abstract
Immune thrombocytopenic purpura in children who fail to respond to medical therapy requires splenectomy. Single-incision laparoscopic splenectomy is a method that has been increasingly used in both adult and pediatric patients. Objectives: To evaluate outcomes and prognostic factors for the response after single-incision laparoscopic splenectomy for immune thrombocytopenic purpura in children. Subjects and methods: 55 patients were diagnosed with immune thrombocytopenic purpura and were treated by single incision laparoscopic splenectomy at the Department of Pediatric and Neonatal Surgery - Viet Duc Hospital, from February 2017 to June 2022. Results: All the patients in the study used the Z-skin incision at the umbilicus, the splenic artery and the splenic vein only using LigaSure to control. The average operative time was 83.3 minutes, the mean preoperative platelet count was 89,1 x10^9/L, the average hospital stay was 4.8 days. The average 24-hours postoperative platelet count was 293.8 ± 242.8 x10^9/L, after 7 days it was 233.4 x10^9/L. After 6 months of surgery, most of the pediatric patients responded to treatment, of which about 76% had a complete response and 20% had a partial response. The dose of corticosteroids, the platelet count 7 days after surgery and the patient's age at surgery were statistically significant factors in the postoperative response of the pediatric patient (p<0.05). Conclusion: Single-incision laparoscopic splenectomy is a safe and effective method in the treatment of patients with chronic immune thrombocytopenic purpura in children.
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Keywords
Single-incision laparoscopic splenectomy, immune thrombocytopenic purpura.
References
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