Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Dec 2002
Laparoscopic splenectomy for idiopathic thrombocytopenic purpura.
We conducted a retrospective multicenter study by questionnaire to evaluate the results of laparoscopic splenectomy for idiopathic thrombocytopenic purpura (ITP). Between 1991 and 1998, 209 patients with a mean age of 41.2 years (range, 10-83) had a laparoscopic splenectomy for idiopathic thrombocytopenic purpura. Preoperatively, 178 patients (85%) underwent medical treatment aimed at achieving a satisfactory platelet count. ⋯ It is associated with fewer postoperative complications, a shorter duration of hospitalization and an earlier return to normal activity. The limiting factors are the experience of the operator and patient obesity. The long-term results are identical to those of conventional splenectomy, with a better than average success rate in patients that have failed preoperative medical treatment.
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Surg Laparosc Endosc Percutan Tech · Dec 2002
Case ReportsRectus sheath hematoma complicating percutaneous endoscopic gastrostomy.
A case is reported of a rectus sheath hematoma occurring as an early consequence of percutaneous endoscopic gastrostomy with hemodynamic compromise. The most likely etiology is damage to the superior epigastric artery intraoperatively. Nonsurgical methods were used to achieve hemodynamic stability. This case illustrates an uncommon complication of gastrostomy tube placement that should be considered early postoperatively for patients with hemodynamic compromise.