AIM: Idiopatic thrombocytopenic purpura (ITP) is the most common indication for splenectomy. The failure rate of surgery is about 8% and the failure rate after splenectomy is approximately 28% for all patients. When the presence of an accessory spleen is diagnosed, splenectomy is recommended. Laparoscopic approach is considered the first choice. PATIENTS AND METHODS: At our Department, between July and November 2011 two patients underwent laparoscopic accessory splenectomy for recurrence of ITP. Both patients had a previously laparoscopic splenectomy. Preoperative Magnetic Resonance (MR) was performed in both the cases revealing the presence of an accessory spleen. RESULTS: The operative time was 105 and 100 minutes respectively. No perioperative complications occured. Hospital stay was four days in both cases. The first patient had a disease free period of two months; the second one of one month. Both patients restarted immunosuppressive therapy. CONCLUSIONS: The relapse of thrombocytopenia post-splenectomy can be associated with the presence of an accessory spleen. The laparoscopic accessory splenectomy should be considered the first choice approach. Surgical accessory splenectomy allows a transitory remission of the disease.
AIM: Idiopatic thrombocytopenic purpura (ITP) is the most common indication for splenectomy. The failure rate of surgery is about 8% and the failure rate after splenectomy is approximately 28% for all patients. When the presence of an accessory spleen is diagnosed, splenectomy is recommended. Laparoscopic approach is considered the first choice. PATIENTS AND METHODS: At our Department, between July and November 2011 two patients underwent laparoscopic accessory splenectomy for recurrence of ITP. Both patients had a previously laparoscopic splenectomy. Preoperative Magnetic Resonance (MR) was performed in both the cases revealing the presence of an accessory spleen. RESULTS: The operative time was 105 and 100 minutes respectively. No perioperative complications occured. Hospital stay was four days in both cases. The first patient had a disease free period of two months; the second one of one month. Both patients restarted immunosuppressive therapy. CONCLUSIONS: The relapse of thrombocytopenia post-splenectomy can be associated with the presence of an accessory spleen. The laparoscopic accessory splenectomy should be considered the first choice approach. Surgical accessory splenectomy allows a transitory remission of the disease.
Authors: T Facon; M T Caulier; P Fenaux; I Plantier; X Marchandise; M Ribet; J P Jouet; F Bauters Journal: Am J Hematol Date: 1992-11 Impact factor: 10.047
Authors: F J Berends; N Schep; M A Cuesta; H J Bonjer; M C Kappers-Klunne; P Huijgens; G Kazemier Journal: Surg Endosc Date: 2004-02-02 Impact factor: 4.584
Authors: Abdulmalik M S Altaf; Mark Sawatzky; James Ellsmere; Hendrik Jaap Bonjer; Steven Burrell; Robert Abraham; Stephen Couban; Dennis Klassen Journal: Surg Endosc Date: 2009-01-23 Impact factor: 4.584