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Laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension

INTRODUCTION: Laparoscopic splenectomy and esophagogastric devascularization (LSED) is becoming increasingly popular in the treatment of esophageal-fundic variceal bleeding with portal hypertension (PHT) in China, and its high safety and minimal trauma have been proven. Fast-track (FT) surgery impro...

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Autores principales: Wang, Dong, Zhang, Zhang, Dong, Rui, Lu, Jianguo, Yin, Jikai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186085/
https://www.ncbi.nlm.nih.gov/pubmed/35707335
http://dx.doi.org/10.5114/wiitm.2021.112680
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author Wang, Dong
Zhang, Zhang
Dong, Rui
Lu, Jianguo
Yin, Jikai
author_facet Wang, Dong
Zhang, Zhang
Dong, Rui
Lu, Jianguo
Yin, Jikai
author_sort Wang, Dong
collection PubMed
description INTRODUCTION: Laparoscopic splenectomy and esophagogastric devascularization (LSED) is becoming increasingly popular in the treatment of esophageal-fundic variceal bleeding with portal hypertension (PHT) in China, and its high safety and minimal trauma have been proven. Fast-track (FT) surgery improves patient recovery and decreases postoperative complications. AIM: To determine whether LSED with fast-track principles can provide better outcomes than traditional treatment for patients with PHT. MATERIAL AND METHODS: A total of 140 patients who underwent LSED with either traditional treatment or fast-track principles in our department were retrospectively analyzed. The postoperative outcomes, complications, inflammatory mediators, portal vein thrombosis (PVT) and recurrent esophagogastric variceal bleeding rate were recorded. RESULTS: No significant differences were found in the patients’ preoperative characteristics. The FT group had better outcomes than the non-FT group with respect to gastrointestinal function recovery, resumption of oral intake, and postoperative hospitalization. The incidence of postoperative complications, including pneumonia, severe ascites, and urinary tract infection, were significantly lower in the FT than the non-FT group. The C-reactive protein and interleukin 6 concentrations and the incidence of PVT were significantly lower in the FT than the non-FT group. The overall recurrent bleeding rate is 11.5% and no significant difference was found between the two groups in the follow-up period. CONCLUSIONS: LSED with fast-track principles was superior to LSED with traditional treatment in terms of postoperative outcomes, complications, postoperative inflammatory reactions, and the incidence of PVT. This strategy is safe and effective for the treatment of PHT.
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spelling pubmed-91860852022-06-14 Laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension Wang, Dong Zhang, Zhang Dong, Rui Lu, Jianguo Yin, Jikai Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: Laparoscopic splenectomy and esophagogastric devascularization (LSED) is becoming increasingly popular in the treatment of esophageal-fundic variceal bleeding with portal hypertension (PHT) in China, and its high safety and minimal trauma have been proven. Fast-track (FT) surgery improves patient recovery and decreases postoperative complications. AIM: To determine whether LSED with fast-track principles can provide better outcomes than traditional treatment for patients with PHT. MATERIAL AND METHODS: A total of 140 patients who underwent LSED with either traditional treatment or fast-track principles in our department were retrospectively analyzed. The postoperative outcomes, complications, inflammatory mediators, portal vein thrombosis (PVT) and recurrent esophagogastric variceal bleeding rate were recorded. RESULTS: No significant differences were found in the patients’ preoperative characteristics. The FT group had better outcomes than the non-FT group with respect to gastrointestinal function recovery, resumption of oral intake, and postoperative hospitalization. The incidence of postoperative complications, including pneumonia, severe ascites, and urinary tract infection, were significantly lower in the FT than the non-FT group. The C-reactive protein and interleukin 6 concentrations and the incidence of PVT were significantly lower in the FT than the non-FT group. The overall recurrent bleeding rate is 11.5% and no significant difference was found between the two groups in the follow-up period. CONCLUSIONS: LSED with fast-track principles was superior to LSED with traditional treatment in terms of postoperative outcomes, complications, postoperative inflammatory reactions, and the incidence of PVT. This strategy is safe and effective for the treatment of PHT. Termedia Publishing House 2022-01-19 2022-06 /pmc/articles/PMC9186085/ /pubmed/35707335 http://dx.doi.org/10.5114/wiitm.2021.112680 Text en Copyright: © 2022 Fundacja Videochirurgii https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Wang, Dong
Zhang, Zhang
Dong, Rui
Lu, Jianguo
Yin, Jikai
Laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension
title Laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension
title_full Laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension
title_fullStr Laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension
title_full_unstemmed Laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension
title_short Laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension
title_sort laparoscopic splenectomy and esophagogastric devascularization combined with fast-track principles offers greater benefit for patients with portal hypertension
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186085/
https://www.ncbi.nlm.nih.gov/pubmed/35707335
http://dx.doi.org/10.5114/wiitm.2021.112680
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