Grande RCI, Lozano LL

Language: Spanish
References: 15
Page: 29-34
PDF size: 2395.63 Kb.

ABSTRACT

Introduction: immune thrombocytopenia is an acquired disorder characterized by autoantibody-mediated platelet destruction. In Mexico, its estimated prevalence is 9.5 cases per 100,000 population. Splenectomy is a therapeutic option in refractory cases, and the laparoscopic approach is currently considered the gold standard due to its significant advantages, although it requires an individualized assessment of risks and benefits. Objective: to present a case of laparoscopic splenectomy using a lateral approach in a patient with refractory immune thrombocytopenia, emphasizing the efficacy and safety of the minimally invasive technique. Clinical case: a 26-year-old male with a one-year history of immune thrombocytopenia refractory to medical treatment was referred for surgical management after a transient increase in platelet count with a thrombopoietin receptor agonist. Laparoscopic splenectomy was performed in the right lateral decubitus position, revealing an enlarged spleen (13 × 12 × 10 cm). The postoperative course was favorable, and the patient was discharged on postoperative day three with a platelet count of 169,000/μl. Conclusion: laparoscopic splenectomy via a lateral approach is a safe and effective option for patients with refractory immune thrombocytopenia, offering advantages over conventional surgery. Proper patient selection, individualized surgical planning, and multidisciplinary management are essential for optimal outcomes.

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