Abstract:
BACKGROUND:Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder for which appropriate diagnostic treatments are uncertain. The response to splenectomy varies from 60% to 90%, and the remaining patients relapse and require further treatment. Therefore, it is important to predict the outcome of splenectomy before and after surgery. The objective of this study was to evaluate the efficacy of splenectomy in patients diagnosed with ITP. MATERIALS AND METHODS:From 1988 to 2004, we splenectomized 32 patients with ITP; 17 underwent laparoscopic splenectomy (LS) and 15 underwent conventional open splenectomy (OS). For analysis, patients were separated retrospectively into two groups: the "responding group," those who showed good outcomes with splenectomy, and the "non-responding group," those who did not show good outcomes with splenectomy. Blood samples were examined before and immediately after surgery (day 0) and on postoperative days (POD) 1, 3, 5, and 7. RESULTS:The median follow-up was 8.3 years (range: 1-16 years). The overall 5- and 10-year survival rates after splenectomy were 96.9% (one death). The responding group included 24 patients (75%), and the non-responding group included 7 (21.9%). Platelet counts in the responding group increased gradually until POD 7, and although platelet counts in the non-responding group were almost constant until POD 5, they subsequently decreased until POD 7. Average platelet counts in the responding and non-responding groups were 269 and 124 x 10(9)/l on POD 7, respectively (P < 0.05). The pre- to post-surgery ratio of platelet counts were almost the same as the result of the actual data. Platelet counts during the long-term follow-up for the responding and non-responding groups were related to those noted on discharge. CONCLUSIONS:A high platelet count on POD 7 was associated with a good response to splenectomy, but age at surgery, the time interval between diagnosis and splenectomy, and prior responses to corticosteroid were not. We suggest that long-term outcomes of splenectomy can easily be predicted by platelet counts on POD 7.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Ojima H,Kato T,Araki K,Okamura K,Manda R,Hirayama I,Hosouchi Y,Nishida Y,Kuwano Hdoi
10.1007/s00268-005-7964-0keywords:
subject
Has Abstractpub_date
2006-04-01 00:00:00pages
553-9issue
4eissn
0364-2313issn
1432-2323journal_volume
30pub_type
杂志文章abstract::The clinicopathological characteristics relevant to prognosis after surgical treatment of intrahepatic cholangiocarcinoma (ICC) remain unclear. In this study, the clinicopathological features of 19 patients with mass-forming ICC, the most common form of the disease, were reviewed to analyze prognostic determinants. Tw...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0291-1
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Substernal thyroidectomy (ST), as compared to conventional, cervical thyroidectomy, is a technically demanding procedure that is associated with increased morbidity and mortality. We tested the hypothesis that outcomes following ST are improved at centers that perform a high volume of thyroidectomies. METHO...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9347-1
更新日期:2008-05-01 00:00:00
abstract:INTRODUCTION:The follicular variant of papillary thyroid carcinoma (FVPTC) is the most common histologic subtype of papillary thyroid carcinoma (PTC). However, it is still controversial whether FVPTC should behave differently from classical PTC (CPTC). The present study aimed at evaluating any potential difference in c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0356-7
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the relationship between the method of transport after injury and survival among trauma patients admitted to a Level 1 trauma facility in Los Angeles, California. METHODS:The trauma registry of LAC+USC Medical Center was reviewed to identify all injured patients ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0185-1
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Unrecognized reduction of blood supply to intestinal organs is associated with significant postoperative morbidity in abdominal surgery. The aim of this study was to determine whether--in the absence of hypovolemia--intestinal hypoperfusion as a result of blood flow redistribution occurs after abdominal surg...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0560-y
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Most reconstructive surgery in Sub-Saharan Africa is provided by numerous noncoordinated individuals and organizations, in multiple short trips, or "surgical blitzes." Because many such groups do not train local surgeons, these communities have become dependent on unsustainable systems. By providing much-nee...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0256-3
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Screening of multiple endocrine neoplasia type 1 (MEN-1) patients is widely recommended because one-fifth succumb to malignant neoplasms. However, recommendations for screening modalities and intervals are based mostly on nonprospective data. METHODS:Thirty-five of 48 MEN-1 patients were evaluated at least ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-9983-8
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate the efficacy of 10 % sucralfate ointment in the reduction of acute postoperative pain after open hemorrhoidectomy. METHODS:A total of 48 patients (24 men and 24 women) between 20 and 70 years of age who underwent open hemorrhoidectomy were included in this prospe...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1805-8
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Few clinical studies or randomized clinical trial results have reported the impact of fast-track surgery on human immunity. This study aimed to investigate the clinical and immune impact of fast-track surgery in colorectal cancer patients undergoing elective open surgery. METHODS:A controlled randomized cli...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1606-0
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Macroscopic extrathyroidal extension (ETE) is a poor prognostic factor in papillary thyroid carcinoma (PTC). However, intraoperative inspection for ETE is often inaccurate and could lead the surgeon to misconstrue simple adhesion as gross ETE. Such confusion could result in more aggressive treatment than nec...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2034-5
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:The commonest surgical treatment used for peptic ulcer perforation is omental patching. If, however, the perforation leaks, it rarely heals by itself due to persistence of duodenal fistula (DF). We present our experience with a T-tube placed into the DF for better outcome of the patients. METHODS:All patien...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2196-1
更新日期:2013-11-01 00:00:00
abstract::The post-Soviet calamities of East European cardiac surgery highlight the spectrum of marked differences in overall operative capacities among individual post-Communist countries. A comparison with the level of cardiac surgery in Western Europe reveals the importance of continuing relief, comprising both educational a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7103-8
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Surgery for Graves' disease (GD) is usually performed after adequate control with medical treatment. Occasionally, rapid pre-operative optimization is required. The primary objective was to compare the outcomes of patients undergoing elective surgery for well-controlled GD with those undergoing rapid pre-ope...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05125-5
更新日期:2019-12-01 00:00:00
abstract::With limited resources and the current concerns about using animals for research purposes, the needs must be clear when setting up trauma and sepsis experiments for pharmacologic interventions. Such interventions are performed typically for four reasons: (1) to study the pathophysiologic role of certain mediators (whi...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900077
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Intense disease surveillance and frequent lymph node metastases (LNMs) in papillary thyroid cancer (PTC) have resulted in increased locoregional recurrences. We examined the safety and efficacy of an optimized surgical approach including preoperative ultrasonography (US), bilateral thyroidectomy, routine com...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0307-9
更新日期:2010-06-01 00:00:00
abstract::Node dissection for melanoma remains the most important therapeutic decision for the optimal management of the patient with melanoma. In Australia and in some parts of the United States, the majority of patients with intermediate thickness melanoma (1.6-4.00 mm) will undergo elective lymph node dissection. In Europe, ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract::Surgeons often are faced with the challenge of balancing truth telling and the maintenance of hope in the setting of a poor prognosis. This ethical dilemma is informed by conflicting appeals to principles of autonomy and nonmaleficence, where a patient's right to be told important medical information must be weighed a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2566-3
更新日期:2014-07-01 00:00:00
abstract::Dissemination of new surgical knowledge, skills, and techniques across the wide spectrum of practicing surgeons in the community is often difficult and slow. This is even more problematic in countries such as Canada, where geographic distances separate a large portion of community surgeons from the large teaching cent...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9076-5
更新日期:2007-08-01 00:00:00
abstract::A randomized, double-blind multicenter trial was performed to compare the safety and efficacy of a new low-molecular-weight heparin (LMWH) (LU 47311, Clivarine) and standard unfractionated heparin for the prophylaxis of postoperative venous thromboembolism. Altogether 1351 patients scheduled to undergo abdominal surge...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/s002689900185
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:We have compared the oncologic effectiveness of limited resection (LR) techniques such as transhiatal (TH) or limited resection of the esophagogastric junction with intestinal interposition (LREGJ) in the treatment of early esophageal carcinoma with that of the extended resection such as the classical thorac...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1069-8
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:The objectives of this study were to report the clinical and radiological characteristics and outcomes of a series of acute traumatic aortic injuries (ATAIs) with associated injury to major aortic abdominal visceral branches (MAAVBs). METHODS:From January 2000 to August 2011, 10 consecutive major blunt trau...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1536-x
更新日期:2012-07-01 00:00:00
abstract::The present study documents the indications and results of endoscopic sphincterotomy (ES) performed over 7 years in a surgical endoscopy unit. Potential improvement of results over this time period was analyzed. ES was associated with rare but undesirable morbidity and mortality. Specific improvement of results over t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900195
更新日期:1997-01-01 00:00:00
abstract::A new technique utilizing miniaturized (2 mm) instrumentation to perform laparoscopic cholecystectomy (LC) is introduced. The safety and efficacy of this mini-LC were assessed. Fifty consecutive mini-LCs were performed using one 10-mm port and three 2-mm ports (cumulative port size 16 mm). A 2-mm fiberoptic video-lapa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00013163
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Primary hyperparathyroidism (HPT) is often caused by a benign parathyroid tumor, adenoma; less commonly by multiglandular parathyroid disease/hyperplasia; and rarely by parathyroid carcinoma. Patients with multiple tumors require wider exploration to avoid recurrence and have increased risk for hereditary di...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-009-0022-6
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The lung is the most common site of extrahepatic metastasis from hepatocellular carcinoma (HCC). The aim of this study was to evaluate the significance and long-term outcomes of pulmonary metastasectomy for HCC, especially in patients with multiple nodules or repeated pulmonary recurrence. METHODS:We retros...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3213-3
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Idiopathic granulomatous mastitis (IGM) is a rare, benign, and chronic disease of the breast. Despite the various treatment approaches described for this disease, a gold standard treatment modality has not yet been defined. In this study, the effect of topical steroids was reviewed and assessed in patients w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3147-9
更新日期:2015-11-01 00:00:00
abstract::The phrase "outcomes studies" is usually used to describe those studies where outcome is assessed in large cohorts of patients, often using data from administrative databases. They are used to determine the role and impact of variations in the structure and process of health care delivery play in routine practice. Opt...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900651
更新日期:1999-12-01 00:00:00
abstract::Incisional hernia is a serious postoperative complication of laparotomy. Selecting an appropriate suture material may lessen such morbidity. This study undertook a prospective, randomized comparison of early-absorbable polyglactin 910 suture versus late-absorbable polydioxanone loop suture for fascial closure after ab...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s002689910120
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Patients with end-stage renal disease (ESRD) and secondary hyperparathyroidism (SHPT) are at high risk of mortality. Whether an increased risk of death persists after a parathyroidectomy (PTX) is not clearly established. SUBJECTS AND METHODS:The survival of 40 patients with ESRD and SHPT who underwent PTX w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0693-1
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Despite the good results reported after laparoscopic fundoplication, failure is still a major problem. Hiatal disruption is one of the common patterns of anatomical failure. The aim of this study was to compare the results of suture repair of diaphragmatic crura with routine polypropylene mesh reinforcement ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9066-7
更新日期:2007-11-01 00:00:00