Studies involving patients who underwent splenectomy for refractory thrombotic thrombocytopenic purpura
Study | No. of patients | Surgical method | No. (%) | Follow-up, mean (range), mo.* | Comment | ||
---|---|---|---|---|---|---|---|
Deaths | Complications | Failure to respond to splenectomy | |||||
Thompson and McCarthy23 | 2 | Open | 0 | 1 (50) | 0 | 4, 8 | Complication: Staphylococcal infection |
Evans et al.24 | 2 | Open | 0 | 0 | 0 | 12, 12 | |
Schneider et al.25 | 6 | Open | 0 | 2 (33) | 0 | 11 (6–14) | Complications: pneumonia and postoperative hemorrhage |
Liu et al.7 | 5 | Open | 0 | 0 | 1 (20) | 18 (8–36) | |
Wells et al.8 | 2 | Open | 0 | 0 | 0 | 6, 36 | |
Hayward et al.26 | 13 | Open | 2 (15) | Not reported | 0 | 20 (6–67) | Two deaths following splenectomy, specific cause not reported |
Winslow and Nelson.27 | 6 | Open | 0 | 0 | 0 | 21 (6–38) | |
Rund et al.13 | 2 | Open | 0 | 0 | 1 (50) | 21, 86 | |
Mant et al.28 | 7 | Open | 1(14) | 0 | 1 (14) | 29 (18–37) | One patient failed to respond and died of TTP |
de la Rubia et al.14 | 2 | Laparoscopic | 0 | 0 | 0 | 11, 26 | |
Schwartz et al.15 | 2 | Laparoscopic | 0 | 1 (50) | 1 (50) | † | Complication: postoperative hematoma in splenic bed |
Rosen et al.29 | 9 | Laparoscopic | 0 | 2 (22) | 1 (11) | 13 (1–30) | Complications: 1 diaphragmatic tear and 1 retroperitoneal hematoma |
Aqui et al.19 | 6 | Open | 0 | 0 | 0 | 147 (72–176) | |
Kremer Hovinga et al.21 | 1 | Not reported | 0 | 0 | 0 | 46 | |
Kappers-Klunne et al.5 | 9 | Open‡ | 1 (11) | 1 (11) | 1 (11) | 92 (28–201) | One patient did not respond and died of TTP postoperatively, 1 patient developed a pulmonary embolism postoperatively |
Total | 74 | 4 (5) | 7 (10)§ | 6 (8) |