Abstract: The role of surgery in the treatment of immune thrombocytopenic purpura (ITP) is still discussed. The aim of this study was to verify our criteria of patient selection for splenectomy, to analyze the results of a protocol for the evaluation of the hemorragic risk, and to discuss long-term results of 70 patients with ITP who underwent surgical treatment from 1984 to 1990. All patients received steroid therapy. Sixty-two patients were given high doses of IgG (600 mg/kg/iv bolus) pre-operatively in order to obviate the need for intra-operative platelet transfusions. Forty-three patients showed a significant increase in the platelet count, 8 a moderate increase, while 11 patients did not respond. No operative mortality was observed, however postoperative minor complications occurred in 14 (20%) patients. Accessory spleens were found in 11 (15.7%) patients. Mean follow-up was 21 months. Response to splenectomy was considered as complete (platelets > 150,000 mm3 with no need for medical treatment) in 63 (90%) patients. No response was observed in 7 patients. In 2 of the non-responders postoperative indium-111 scan revealed accessory spleens and ITP remitted after accessory splenectomy. All non-responders were in the group of patients who did not respond to the pre-operative infusion of high dose IgG. It can be concluded that splenectomy is a safe and effective treatment for ITP and that response to pre-operative infusion of IgG may be considered as predictive for the outcome after splenectomy.

Surgical treatment of immune thrombocytopenic purpura / Chirletti, Piero; Cardi, Maurizio; Barillari, Paolo; Vitale, A; Sammartino, Paolo; Bolognese, Antonio; Caiazzo, R; Ricci, M; Muttillo, Ia; Stipa, Vincenzo. - In: WORLD JOURNAL OF SURGERY. - ISSN 0364-2313. - 16:(1992), pp. 1001-1004. [10.1007/BF02067017]

Surgical treatment of immune thrombocytopenic purpura.

CHIRLETTI, Piero;CARDI, Maurizio;BARILLARI, Paolo;SAMMARTINO, Paolo;BOLOGNESE, Antonio;STIPA, Vincenzo
1992

Abstract

Abstract: The role of surgery in the treatment of immune thrombocytopenic purpura (ITP) is still discussed. The aim of this study was to verify our criteria of patient selection for splenectomy, to analyze the results of a protocol for the evaluation of the hemorragic risk, and to discuss long-term results of 70 patients with ITP who underwent surgical treatment from 1984 to 1990. All patients received steroid therapy. Sixty-two patients were given high doses of IgG (600 mg/kg/iv bolus) pre-operatively in order to obviate the need for intra-operative platelet transfusions. Forty-three patients showed a significant increase in the platelet count, 8 a moderate increase, while 11 patients did not respond. No operative mortality was observed, however postoperative minor complications occurred in 14 (20%) patients. Accessory spleens were found in 11 (15.7%) patients. Mean follow-up was 21 months. Response to splenectomy was considered as complete (platelets > 150,000 mm3 with no need for medical treatment) in 63 (90%) patients. No response was observed in 7 patients. In 2 of the non-responders postoperative indium-111 scan revealed accessory spleens and ITP remitted after accessory splenectomy. All non-responders were in the group of patients who did not respond to the pre-operative infusion of high dose IgG. It can be concluded that splenectomy is a safe and effective treatment for ITP and that response to pre-operative infusion of IgG may be considered as predictive for the outcome after splenectomy.
1992
01 Pubblicazione su rivista::01a Articolo in rivista
Surgical treatment of immune thrombocytopenic purpura / Chirletti, Piero; Cardi, Maurizio; Barillari, Paolo; Vitale, A; Sammartino, Paolo; Bolognese, Antonio; Caiazzo, R; Ricci, M; Muttillo, Ia; Stipa, Vincenzo. - In: WORLD JOURNAL OF SURGERY. - ISSN 0364-2313. - 16:(1992), pp. 1001-1004. [10.1007/BF02067017]
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/115948
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 47
  • ???jsp.display-item.citation.isi??? 42
social impact