{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T17:36:24Z","timestamp":1774114584206,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2005,9,23]],"date-time":"2005-09-23T00:00:00Z","timestamp":1127433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Laparoscopic splenectomy (LS) is now performed routinely in patients with idiopathic thrombocytopenic purpura (ITP) refractory to the medical treatment. Low preoperative platelet count was deemed to be a contraindication for a laparoscopic approach; however, there is no data reporting the outcome in those patients. We aimed to evaluate the influence of the preoperative platelet count on the operative and postoperative course and complication rate. Retrospective cohort study that was conducted in tertiary care university\u2010affiliated medical center and included 110 consecutive patients who underwent LS. All patients were divided into three groups by their preoperative platelet counts: \u226420 \u00d7 10<jats:sup>9<\/jats:sup>\/L (<jats:italic>n<\/jats:italic> = 12), (20\u201350) \u00d7 10<jats:sup>9<\/jats:sup>\/L (<jats:italic>n<\/jats:italic> = 18), and &gt;50 \u00d7 10<jats:sup>9<\/jats:sup>\/L (<jats:italic>n<\/jats:italic> = 80). The outcome and the influence of preoperative factors predictive of complications, blood transfusion, and length of stay were compared between the groups. Patients with a platelet count of \u226420 \u00d7 10<jats:sup>9<\/jats:sup>\/L had a much longer hospital stay, received more blood transfusions, and suffered more complications than patients with platelet counts of (20\u201350) \u00d7 10<jats:sup>9<\/jats:sup>\/L or higher (<jats:italic>P<\/jats:italic> &lt; 0.05). Transfused patients had a longer hospital stay than non\u2010transfused patients (2.08 vs. 6.4 days, <jats:italic>P<\/jats:italic> = 0.029). The strongest predictor for transfusion was the platelet count (odds ratio = 23, <jats:italic>P<\/jats:italic> = 0.008). LS in patients with very low platelet counts is feasible and reasonably safe, but the platelet count is a major determinant of morbidity. Every effort should be made to elevate platelet levels to &gt;20 \u00d7 10<jats:sup>9<\/jats:sup>\/L before surgery. Patients with counts &gt;20 \u00d7 10<jats:sup>9<\/jats:sup>\/L can safely undergo LS. Am. J. Hematol. 80:95\u2013100, 2005. \u00a9 2005 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajh.20433","type":"journal-article","created":{"date-parts":[[2005,9,23]],"date-time":"2005-09-23T18:50:26Z","timestamp":1127501426000},"page":"95-100","source":"Crossref","is-referenced-by-count":44,"title":["Analysis of outcome of laparoscopic splenectomy for idiopathic thrombocytopenic purpura by platelet count"],"prefix":"10.1002","volume":"80","author":[{"given":"A.","family":"Keidar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Feldman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Szold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,9,23]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1182\/blood.V88.1.3.3","article-title":"Idiopathic thrombocytopenic purpura: a practical guideline developed by explicit methods for the American Society of Hematology","volume":"88","author":"George JN","year":"1996","journal-title":"Blood"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800791230"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(98)00209-8"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199810000-00013"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(200001)63:1<7::AID-AJH2>3.0.CO;2-1"},{"key":"e_1_2_1_7_2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1177\/000313480106700112","article-title":"The ascendance of laparoscopic splenectomy","volume":"67","author":"Walsh RM","year":"2001","journal-title":"Am Surg"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004640000355"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2402129"},{"key":"e_1_2_1_10_2","first-page":"256","article-title":"High\u2010dose dexamethasone for splenectomy in patients with idiopathic thrombocytopenic purpura","volume":"28","author":"Bulvik S","year":"1998","journal-title":"Haemostasis"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004649900784"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2000.109065"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(96)00241-3"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra010501"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-03-1168"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830460212"},{"key":"e_1_2_1_17_2","first-page":"250","article-title":"Massive intracranial bleeding requiring emergency splenectomy in a patient with CMV\u2010associated thrombocytopenia","volume":"28","author":"Gural A","year":"1998","journal-title":"Haemostasis"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V77.1.31.31"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004649901100"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.20433","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.20433","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T07:33:47Z","timestamp":1700206427000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.20433"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,9,23]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2005,10]]}},"alternative-id":["10.1002\/ajh.20433"],"URL":"https:\/\/doi.org\/10.1002\/ajh.20433","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,9,23]]}}}