Multivariate Analysis Of The Efficacy Of Laparoscopic Splenectomy In The Treatment Of Immune Thrombocytopenic Purpura

Objective: To identify factors that can effectively predict the efficacy of laparoscopic splenectomy(LS) in the treatment of immune thrombocytopenic purpura(ITP), to slect proper ITP patients for LS.Methods: From January2007to September2012, seventy-eight patients with ITP in Hepatobiliary Surgery Department of the First Affiliated Hospital of Chongqing Medical University underwent laparoscopic splenectomy were retrospectively analyzed. According to the postoperative platelet(PLT) count, they were divided into effective group (65cases)and ineffective group (13cases). At first, nine influencing factors include gender,age,disease duration,PLT count of one day before surgery,preoperative response to hormones,preoperative complications, accessory spleen,operative time,intraoperative blood loss, which might affect the efficacy of LS in the treatment of ITP were univariate analyzed. Then, factors which had statistically significance were multivariate analyzed by binary logistic regression. Statistical analysis used SPSS19.0software.Results: In effective group and ineffective group, PLT count of on e day before surgery was47×109/L and21×109/L, operative time was(165.85±45.945)min and (139.23±28.639)min. Univariate analysis result:PLT count of one day before surgery (P=0.005<0.05) and operativetime (P=0.011<0.05) was statistically significant in two groups, the rest factors did not significantly influence the result. Multivariate analysis revealed that only PLT count of one day before surgery was statistically significant (P=0.031<0.05) in two groups, but operative time (P=0.051>0.05) was not statistically significant.Conclusions: PLT count of one day before surgery is a predict factor in LS for ITP. But，further multi-center prospective study with largesample is needed to identify the factors which can really predict the efficacy of LS for ITP management.