Comparison of clinical efficacy of laparoscopic splenectomy versus open splenectomy for idiopathic thrombocytopenic purpura: A meta-analysis

BACKGROUND: The purpose of this study is to compare the clinical efficacy of laparoscopic splenectomy (LS) and open splenectomy (OS) in the treatment of Idiopathic thrombocytopenic purpura. METHODS: We systematically searched PubMed, Web of science, EMBASE, Clinicaltrials.gov, and Cochrane Central Register for studies (study published from July 1992–January 2020). This study analyzed the clinical effect of LS and OS on idiopathic thrombocytopenic purpur. RESULTS: This study showed that compared with OS, the LS's Overall response (OR: 0.60, 95% confidence interval (CI): 0.23–1.59, P = .30), Complication (OR: 0.59, 95% CI: 0.18–1.94, P = .38), Accessory spleen(OR: 1.70, 95% CI: 0.98–2.98, P = .06), Wound infections (OR: 0.65, 95% CI: 0.26–1.59, P = .34), Pancreatic fistula (OR: 0.73, 95% CI: 0.16–3.30, P = .68), was no significant, the Operative time (weighted mean difference (WMD): 49.33, 95% CI: 36.29–62.37, P < .00001)was longer, and the Estimated blood loss (WMD: –172.59, 95% CI: –319.96 to –25.22, P = .02), Postoperative length of stay (WMD: –4.68, 95% CI: –7.75 to –1.62, P = .003)was less. CONCLUSIONS: The therapeutic effect of LS was the same as that of OS in Overall response Complication Accessory spleen, while The operative time was longer, the Estimated blood loss was less, and the postoperative length of stay was shorter.