Laparoscopic splenectomy for hematologic diseases.

Kazuo Tanoue; Keishi Okita; Tomohiko Akahoshi; Kouzou Konishi; Norikazu Gotoh; Norifumi Tsutsumi; Morimasa Tomikawa; Makoto Hashizume

doi:10.1067/msy.2002.120121

PubMed · 11821831

Laparoscopic splenectomy for hematologic diseases.

Kazuo Tanoue·Keishi Okita·Tomohiko Akahoshi·Kouzou Konishi·Norikazu Gotoh·Norifumi Tsutsumi·Morimasa Tomikawa·Makoto Hashizume

View original source ↗Export metadata ↓

Abstract

BACKGROUND: Laparoscopic splenectomy has been demonstrated to be technically feasible and safe for the treatment of hematologic diseases. METHODS: The study comprised 64 consecutive patients with chronic immune thrombocytopenia purpura (ITP) who were admitted to our hospital from 1992 to 2000 and underwent laparoscopic splenectomy. Forty-one consecutive patients with ITP who underwent open splenectomy performed at the same hospital by the same surgical team between 1986 and 2000 were selected as the control group. RESULTS: We performed laparoscopic splenectomies for ITP, hereditary spherocytosis (HS), malignant lymphoma, autoimmune hemolytic anemia, and cryoglobulinemia. Laparoscopic surgery as compared with open surgery in ITP revealed a significantly lower pain medication requirement, an earlier resumption of oral intake, and a shorter hospital stay, but a longer operative time. During the present study (range: 3.8-80 months), the cumulative rate of nonrecurrence was 67.9% at 5 years after surgery, which was similar to the rate for the previous open splenectomy. CONCLUSIONS: Laparoscopic splenectomy is considered to be a suitable alternative therapeutic modality in the treatment of hematologic diseases.

Explore related subjects

Anemia, Hemolytic Cryoglobulinemia Female Humans Laparoscopy Lymphoma Male Purpura, Thrombocytopenic, Idiopathic Recurrence Retrospective Studies Spherocytosis, Hereditary Splenectomy Comparative Study Journal Article

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

Kazuo Tanoue, Keishi Okita, Tomohiko Akahoshi, Kouzou Konishi, Norikazu Gotoh, Norifumi Tsutsumi, Morimasa Tomikawa, Makoto Hashizume. 2002. Laparoscopic splenectomy for hematologic diseases.. https://doi.org/10.1067/msy.2002.120121

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Minimal-change nephropathy and chronic hepatitis C infection: coincidental or associated?

Explore the source record for details and available documents.

Anemia, Hemolytic↗

PubMed2007

Management of cancer-associated thrombotic microangiopathy: what is the right approach?

A 49-year-old Caucasian woman presented with features suggestive of thrombotic microangiopathy (TMA). She did not respond to treatment with repeated plasma exchange and corticosteroids. A bone marrow biopsy revealed presence of metastatic carcinoma. A limited autopsy revealed presence of breast cancer with rib metastases. Though severe deficiency of von Willebrand factor-cleaving protease was initially proposed as a key pathogenetic factor for thrombotic thrombocytopenic purpura, subsequent studies involving patients with cancer-associated TMA did not find as severe a deficiency of von Willebrand factor-cleaving protease as is seen in idiopathic cases of thrombotic thrombocytopenic purpura. Here we address one approach of management of these patients with cancer-associated TMA.

Anemia, Hemolytic↗

PubMed2006

A toxicogenomic approach revealed hepatic gene expression changes mechanistically linked to drug-induced hemolytic anemia.

A variety of pharmaceutical compounds causes hemolytic anemia as a significant adverse effect and this toxicity restricts the clinical utility of these drugs. In this study, we applied microarray technology to investigate hepatic gene expression changes associated with drug-induced hemolytic anemia and to identify potential biomarker genes for this hematotoxicity. We treated female Sprague-Dawley rats with two hemolytic anemia-inducing compounds: phenylhydrazine and phenacetin. Hepatic gene expression profiles were obtained using a whole-genome oligonucleotide microarray with pooled RNA samples from individual rats within each dose group and analyzed in comparison with hepatic histopathology, hematology, and blood chemistry data. We identified a small subset of genes that were commonly deregulated in all the severe hemolytic conditions, some of which were considered to be involved in hepatic events characteristic of hemolytic anemia, such as hemoglobin biosynthesis, heme metabolism, and phagocytosis. Among them, we selected six upregulated genes as putative biomarkers, and their expression changes from microarray measurements were confirmed by quantitative real-time PCR using RNAs from individual animals. They were Alas2, beta-glo, Eraf, Hmox1, Lgals3, and Rhced. Expression patterns of all these genes showed high negative and positive correlation against erythrocyte counts and total bilirubin levels in circulation, respectively, suggesting that these genes may be the potential biomarkers for hemolytic anemia. These findings indicate that drug-induced hemolytic anemia may be detected based on hepatic changes in the expression of a subset of genes that are mechanistically linked to the hematotoxicity.

Anemia, Hemolytic↗