Effectiveness and Reliability of Splenectomy in Chronic Immune Thrombocytopenia

Although splenectomy is markedly effective treatment modality at early period in adult chronic immune thrombocytopenia (ITP), long-term outcomes are still controversial. The aim of this study was to determine long-term effectiveness and reliability of splenectomy in ITP and to identify factors influencing on long-term response. The study included 100 ITP patients who underwent splenectomy in our General Surgery Department between 1980 and 2004. Parameters including gender, age, platelet count, comorbid diseases, antiplatelet antibody positivity and long-term effect of medical treatment on response to splenectomy were considered. Owing to advances in treatment protocols, ITP has become a more benign disease and need for splenectomy has been decreased. However, splenectomy is a highly effective in second-line treatment. Based on our results, it was seen that open or laparoscopic splenectomy with low morbidity and mortality rates is an appropriate treatment modality for long-term control of chronic ITP in cases requiring splenectomy. Age and postoperative platelet count were identified as significant prognostic and predictive factors for long-term response to splenectomy.