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©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Jul 21, 2014; 20(27): 9146-9153
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9146
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9146
Table 1 Baseline demographic and clinical characteristics of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
Variable | MLSD (n = 44) | OSD (n = 71) | P value |
Gender, M/F, n | 27/17 | 41/30 | 0.701 |
Age, mean ± SD, yr | 54.98 ± 10.41 | 52.46 ± 10.33 | 0.209 |
Etiology, n | |||
HBV cirrhosis | 23 | 46 | 0.183 |
HCV cirrhosis | 3 | 5 | 0.963 |
Schistosome cirrhosis | 6 | 9 | 0.882 |
Alcoholic cirrhosis | 3 | 4 | 0.796 |
Autoimmunity liver cirrhosis | 9 | 7 | 0.111 |
APACHE II score, mean ± SD | 3.32 ± 2.27 | 3.49 ± 2.57 | 0.712 |
Child-Pugh classification, A/B, n | 29/15 | 39/32 | 0.244 |
Longitudinal diameter of spleen, mean ± SD, mm | 179.45 ± 27.88 | 185.44 ± 33.24 | 0.321 |
WBC, mean ± SD, 109/L | 2.89 ± 1.65 | 3.07 ± 1.85 | 0.596 |
Hb , mean ± SD, g/dL | 104.16 ± 26.95 | 95.34 ± 28.14 | 1.000 |
PLT, mean ± SD, 109/L | 40.32 ± 7.74 | 38.24 ± 9.18 | 0.214 |
TBIL, mean ± SD, μmol/L | 19.21 ± 9.76 | 20.88 ± 12.66 | 0.454 |
AST, mean ± SD, U/L | 34.93 ± 21.26 | 35.89 ± 15.08 | 0.779 |
ALT, mean ± SD, U/L | 31.14 ± 23.91 | 29.41 ± 15.28 | 0.637 |
BUN, mean ± SD, mmol/L | 5.93 ± 2.25 | 5.38 ± 1.95 | 0.168 |
CER, mean ± SD, μmol/L | 72.32 ± 17.63 | 71.15 ± 19.81 | 0.748 |
Table 2 Intraoperative and postoperative characteristics of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
Variable | MLSD (n = 44) | OSD (n = 71) | P value |
Operation time, median (range), min | 210 (140-390) | 180 (110-300) | < 0.0001 |
Estimated blood loss, median (range), mL | 150 (50-800) | 300 (50-1200) | < 0.0001 |
Blood transfused, median (range), mL | 0 (0-400) | 0 (0-700) | 0.024 |
VAS pain score on the first day, mean ± SD | 2.50 ± 0.85 | 5.06 ± 1.08 | < 0.0001 |
Time to first oral intake, mean ± SD, d | 1.52 ± 0.63 | 2.76 ± 0.62 | < 0.0001 |
Time to first flatus, mean ± SD, d | 2.36 ± 0.97 | 3.18 ± 1.00 | 0.0004 |
Time to off-bed activity, mean ± SD, d | 2.59 ± 0.69 | 5.96 ± 0.93 | < 0.0001 |
Postoperative hospital stay, median (range), d | 10 (7-18) | 15 (7-28) | < 0.0001 |
Perioperative complications, n | 7 | 26 | 0.017 |
Incision complications | 0 | 9 | 0.035 |
Incision hernia | 0 | 1 | |
Superficial SSI | 0 | 5 | |
Deep SSI | 0 | 3 | |
Pneumonia | 0 | 3 | 0.436 |
Organ space SSI | 0 | 2 | 0.697 |
Emergency operation for bleeding | 0 | 3 | 0.436 |
Pancreatic fistula | 2 | 1 | 0.672 |
Asymptomatic portal vein thrombosis | 5 | 8 | 1.000 |
Table 3 Postoperative fever and white blood cell counts of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
Variable | MLSD (n = 44) | OSD (n = 71) | P value |
Postoperative fever, mean ± SD, d | 4.09 ± 3.16 | 6.89 ± 3.55 | < 0.0001 |
No fever, n | 7 | 2 | 0.029 |
WBC 0 d, mean ± SD, 109/L | 2.89 ± 1.65 | 3.07 ± 1.85 | 0.596 |
WBC 1 d, median (range), 109/L | 11.45 (5.2-17.4) | 16.9 (6.1-33.90) | < 0.0001 |
WBC 3 d, mean ± SD, 109/L | 11.63 ± 3.29 | 13.72 ± 4.67 | 0.011 |
WBC 7 d, median (range), 109/L | 8.4 (5-23.1) | 9.5 (4.9-38) | 0.035 |
Normal WBC, 1 d, n | 15 | 3 | < 0.0001 |
Normal WBC, 3 d, n | 14 | 10 | 0.023 |
Normal WBC, 7 d, n | 36 | 39 | 0.003 |
Table 4 Postoperative liver and renal functions of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
Variable | MLSD (n = 44) | OSD (n = 71) | P value |
AST 1 d, mean ± SD, U/L | 57.32 ± 27.89 | 87.14 ± 135.13 | 0.152 |
AST 3 d, mean ± SD, U/L | 33.84 ± 22.16 | 50.86 ± 43.83 | 0.018 |
AST 7 d, mean ± SD, U/L | 25.66 ± 11.28 | 33.63 ± 16.32 | 0.005 |
ALT 1 d, mean ± SD, U/L | 40.14 ± 18.81 | 61.66 ± 105.43 | 0.183 |
ALT 3 d, mean ± SD, U/L | 31.93 ± 25.21 | 46.93 ± 56.60 | 0.100 |
ALT 7 d, mean ± SD, U/L | 21.14 ± 12.63 | 29.68 ± 17.36 | 0.003 |
BUN 1 d, mean ± SD, mmol/L | 5.52 ± 1.76 | 6.54 ± 2.33 | 0.014 |
BUN 3 d, mean ± SD, mmol/L | 6.63 ± 2.20 | 7.33 ± 2.85 | 0.171 |
BUN 7 d, mean ± SD, mmol/L | 4.76 ± 2.02 | 5.52 ± 2.21 | 0.069 |
CER 1 d, mean ± SD, μmol/L | 75.27 ± 16.22 | 84.99 ± 20.92 | 0.010 |
CER 3 d, mean ± SD, μmol/L | 59.75 ± 16.64 | 66.04 ± 19.08 | 0.074 |
CER 7 d, mean ± SD, μmol/L | 60.88 ± 13.92 | 60.83 ± 16.17 | 0.986 |
Table 5 Perioperative C-reactive protein, interleukin-6, and procalcitonin concentrations of the modified laparoscopic splenectomy and azygoportal disconnection and open splenectomy and azygoportal disconnection groups
Variable | MLSD (n = 44) | OSD (n = 71) | P value |
CRP day 0, median (range), mg/L | 1.03 (0.02-49.21) | 0.96 (0.03-13.32) | 0.715 |
CRP day 1, mean ± SD, mg/L | 28.39 ± 16.30 | 36.86 ± 12.86 | 0.002 |
CRP day 3, mean ± SD, mg/L | 92.64 ± 53.16 | 114.06 ± 44.37 | 0.022 |
CRP day 7, mean ± SD, mg/L | 41.14 ± 27.61 | 52.49 ± 29.70 | 0.043 |
IL-6 day 0, mean ± SD, pg/mL | 6.14 ± 5.61 | 6.60 ± 7.26 | 0.715 |
IL-6 day 1, mean ± SD, pg/mL | 8.09 ± 6.97 | 11.78 ± 9.18 | 0.024 |
IL-6 day 3, mean ± SD, pg/mL | 7.65 ± 6.95 | 10.84 ± 8.42 | 0.037 |
IL-6 day 7, mean ± SD, pg/mL | 6.58 ± 5.66 | 9.83 ± 8.26 | 0.024 |
PCT day 0, mean ± SD, ng/mL | 0.45 ± 0.25 | 0.47 ± 0.27 | 0.722 |
PCT 1 d, median (range), ng/mL | 0.97 (0.36-3.2) | 1.96 (0.54-10.08) | < 0.0001 |
PCT 3 d, median (range), ng/mL | 0.795 (0.3-2.67) | 1.45 (0.6-4.88) | < 0.0001 |
PCT 7 d, median (range), ng/mL | 0.5 (0.28-4.01) | 0.77 (0.38-5.87) | < 0.0001 |
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Citation: Jiang GQ, Chen P, Qian JJ, Yao J, Wang XD, Jin SJ, Bai DS. Perioperative advantages of modified laparoscopic
vs open splenectomy and azygoportal disconnection. World J Gastroenterol 2014; 20(27): 9146-9153 - URL: https://www.wjgnet.com/1007-9327/full/v20/i27/9146.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i27.9146