Is ITP really a desirable indication for teaching laparoscopic splenectomy? Cohort study.

: We aimed to evaluate the outcomes of laparoscopic splenectomy (LS) in patients with immune thrombocytopenic purpura (ITP) compared with operated for other indications. : Retrospective cohort study of patients who underwent LS in 1998-2017. Group 1 consisted of 256 patients operated for ITP, and Group 2 of 231 operated for other indications. Primary outcome was procedure difficulty. Secondary was perioperative course (30 days of surgery). : Patients in Group 1 were younger ( < .001) with lower ASA ( < .001). The spleen was larger in Group 2 ( < .001). Operative time was longer in Group 2 [110 (80-150) vs. 90 (65-115) min;  < .001)]. Intraoperative blood loss was greater in Group 2 ( < .001). Conversions were higher in Group 2 (4.76 vs. 6.93%,  = .037), as were intraoperative complications (7.79 vs. 3.91%,  = .048). Morbidity, reoperations and mortality did not differ between groups (respectively,  = .899, .697, and .999). Median length of stay was similar ( = .211). Among the first 10 LSs performed by trainees, 63.66% were done for ITP. Later (after 11+ procedures) this dropped to 48.12% ( = .002). ITP may be a preferred indication for surgeons training for LS. Patients' characteristics and intraoperative factors allow an expectation for a relatively easy and hassle-free operation in those patients.