Purpose: There are two choices of treatment of idiopathic thrombocytic purpura (ITP), medical treatment and splenectomy. Splenectomy is considered as treatment when medical treatment is failed or adverse effect is developed. There are two forms of splenectomy, conventional open method or laparoscopic splenectomy (LS). In this study, we evaluate differences of these forms of splenectomy in outcomes of treatments, and merit of laparoscopy and etc. Methods: Forty five patients undergoing splenetomy for intractable benign hematologic disorders at the Department of Surgery, Chonnam National University Hospital from June 1995 to December 2004. From 45 cases, 32 cases with ITP who had not responded to medical treatment underwent splenectomy. Data were assessed retrospectively by clinical records review. Results: Twenty patients underwent laparoscopic splenectomy except 2 patients who were needed for conversion toopen splenectomy. The mean operation time for LS was longer than for open splenectomy significant in statistically (174.0⁑39.8 vs 106.5⁑88.8 minutes, p=0.007). The mean postoperative hospital stay was shorter in the LS group (6.5⁑2.1 vs 9.2⁑2.5). Also the LS group was had earlier postoperative feeding (1.2⁑0.4 vs 1.7⁑1.0, p=0.002). Complete remission rate was 90% for LS and 80% for open surgery, but not significant in statistically. Conclusion: LS for ITP patients has benefits for cosmetic and decreasing of hospital stay compare to open method. And the therapeutic effect of LS is same with open splenectomy and it is performed safely.

Keywords: Purpura, Thrombocytopenic, Idiopathic, Laparoscopy, Splenectomy, Spleen