en Surgery Surgery Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0000ff;"><em><strong>Background:</strong> </em></span>Chronic idiopathic thrombocytopenic purpura (ITP), is an autoimmune disease associated with a reduction in circulating blood platelets under 150x10⁹/L which persists longer than 6 months without any specific cause. With the current&nbsp;study,&nbsp;we&nbsp;aimed&nbsp;to&nbsp;evaluate the efficacy and safety of laparoscopic splenectomy in ITP patients with a very low platelet count and normal coagulation status.<br> <span style="color:#0000ff;"><em><strong>Methods:</strong></em></span> From April 2007 to January 2012, laparoscopic splenectomy was performed on 60 patients with chronic ITP who could not achieve a sustained recovery after steroid therapy.<br> <span style="color:#0000ff;"><em><strong>Results:</strong></em></span> Patients consisted of male/female&nbsp;ratio of 24 (40%):36 (60%) with the mean age of 53&plusmn;15.1 years. All patients had normal coagulation state even with very low platelet count (below 5&times;10³) before laparoscopic splenectomy. The mean operative time was 140.00&plusmn;15.00 minutes. Blood transfusion was required in 10 (16.7%) and 8 (13.3%) patients before and after the operation, respectively. Preoperative transfusion of PRBC was not statistically significant between groups (P=0.265). Bleeding complications during within or after surgery was rare (5.0%). Convalescence was rapid and the mean hospital stay was 3.58&plusmn;0.68 days (1-14 days) which shows that there was no significant difference in operative time and after operative hospitalization time among the three groups (P=0.070). The patients made a good uneventful recovery and were followed for at least one week who exhibited no postoperative problems.<br> <strong><span style="color:#0000ff;"><em>Conclusion:</em></span> </strong>Laparoscopic splenectomy should be considered initially in the management of ITP. Also, very low platelet count should not be contraindicated for laparoscopic splenectomy in ITP patients and sometimes perioperative platelet transfusion may be unnecessary.</span></span> Laparoscopy, Splenectomy, Purpura, Thrombocytopenic, Idiopathic, Steroids 368 374 http://caspjim.com/browse.php?a_code=A-10-128-3&slc_lang=en&sid=1 Abbas Abdollahi abdollahia@mums.ac.ir 100319475328460036522 100319475328460036522 Yes Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Seyed Maryam Naghibi naghibi.sh@gmail.com 100319475328460036523 100319475328460036523 No Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Hamed Shariat Razavi 100319475328460036524 100319475328460036524 No Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Alireza Tavassoli tavassolia@mums.ac.ir 100319475328460036525 100319475328460036525 No Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Azadeh Jabbari Nooghabi JabbariNooghabi@gmail.com 100319475328460036526 100319475328460036526 No Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Mehdi Jabbari Nooghabi jabbarim@gmail.com 100319475328460036527 100319475328460036527 No Department of Statistics, Faculty of Mathematical Sciences, Ferdowsi University of Medical Sciences, Mashhad, Iran