A meta-analysis on the short-term outcomes between laparoscopic versus open splenectomy and azygoportal disconnection in the prevention and treatment of portal hypertension hemorrhage
10.3760/cma.j.issn.1007-8118.2018.04.011
- VernacularTitle:腹腔镜与开腹脾切除门奇静脉断流术防治门静脉高压症大出血近期疗效的Meta分析
- Author:
Jiangen HOU
1
;
Buqiang WU
;
Xin DONG
;
Wenwei HU
;
Jun QIN
;
Yanqi LI
;
Kun ZHANG
;
Shuaishuai XING
Author Information
1. 长治医学院附属和平医院普外科
- Keywords:
Laparoscopy;
Portal hypertension;
Splenectomy;
Azygoportal disconnection;
Meta-analysis
- From:
Chinese Journal of Hepatobiliary Surgery
2018;24(4):263-267
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the short-term outcomes of laparoscopic splenectomy and azygoportal disconnection (LSD) with open splenectomy and azygoportal disconnection (OSD) in the prevention and treatment of portal hypertension (PHT) hemorrhage.Methods A meta-analysis was conducted to evaluate the short-term outcomes published in randomized controlled studies and high quality casecontrolled studies on patients who underwent LSD or OSD from January 2006 to January 2016.Results 1 359 patients from 18 Chinese and English articles which met the inclusion criteria were included into this study.LSD and OSD were performed in 685 patients (the LSD group) and 674 patients (the OSD group),respectively.Meta-analysis showed that there was no significant difference in operation time between the LSD and OSD groups [MD=17.66,95％CI=(-2.46 ～37.78),P＞0.05].When compared with the OSD group,the LSD group had a shorter postoperative hospitalization stay [MD =-3.99,95％ CI =(-4.82 ～ -3.16),P ＜ 0.05],earlier postoperatively first passing of flatus [MD =-1.09,95％ CI =(-1.41 ～ -0.78),P ＜ 0.05],less intraoperative bleeding [MD =-272.66,95％ CI =(-345.11 ～-200.21),P ＜ 0.05],a lower complication rate [OR =0.34,95％ CI =(0.25 ～ 0.47),P ＜ 0.05],less postoperative pain [MD =-2.54,95％ CI =(-2.79 ～-2.29),P ＜ 0.05],shorter postoperative ambulation time [MD =-3.16,95％ CI =(-3.53 ～-2.79),P ＜ 0.05],less amount of peritoneal drainage [MD =-180.28,95％ CI =(-293.06 ～-67.49),P ＜0.05] and earlier recovery from postoperative loss in appetite [MD =-1.42,95％ CI =(-1.70 ～-1.13),P ＜ 0.05].Conclusion Compared with the traditional OSD,LSD had the advantages of less invasiveness,quicker recovery and higher quality of life in the perioperative period.LSD is the preferred operation for the prevention and treatment of PHT massive hemorrhage.
