| Objective Comparing the clinical data of LS versus OS for hypersplenism secondary to liver cirrhosis,in order to investigate the feasibility and safety of LS for hypersplenism caused by liver cirrhosis and find its advantages and disadvantages.Methods Retrospectively analyze the clinical data of 23 cases with LS for hypersplenism secondary to liver cirrhosis and 23 cases with OS for hypersplenism secondary to liver cirrhosis in general surgery department of Anqing Municipal Hospital affiliated to Anhui Medical University during 2012.01 to 2015.12.Contrastive analysis the clinical data(gender,average age,average weight and so on),operation related index(operation time,incision pain degree,extubation time,postoperative hospital stay time,spleen size),liver function,inflammatory response and immune function of LS group and OS group.Results There were no perioperative death cases in these two groups.23 cases in LS group include 8 male cases and 15 female cases.Among 23 cases,no cases were converted to OS.23 cases in OS group include 10 male cases and 13 female cases.The general clinical data of these two groups,such as the average weight,age and gender,had comparability(P>0.05).They were not statistically significant.The operation indicators include length of incision,drainage tube indwelling time,postoperative hospital stay time and the per capita number of analgesia.The operation indicators of LS group was 4.86±0.49 cm,4.77±1.52 days,7.79±1.28 days,1.91±0.67,but OS group was 15.54±1.30 cm,6.76±2.41 days,11.03±2.73 days,4.00±0.85.Comparing with OS group,the above indexes of LS group had statically significant(P<0.05),reduced significantly.For the average operating time,LS group and OS group time was 101.38±26.25 mins,76.14±15.36 mins respectively.They were statistically significant(P<0.05).The former is obviously longer than the latter.Intraoperative blood loss,the amount of blood used and the maximum diameter of spleen in LS group were 156.42±36.43 ml,243.48±119.95 ml,15.88±1.23 cm respectively,and they were 180.50±48.19 ml,260.15±102.78 ml,16.86±1.50 cm respectively in OS group,which had no statistically significant(P>0.05).LS group postoperative complication rate was 13.04% and OS group was 17.39%.LS group was less than OS group,but with no statistically changes(P>0.05).Liver function: 1day before operation,ALT,AST,Tbil and Dbil of LS group and OS group were no statistically significant(P>0.05).1day and 7days after operation,ALT,AST,Tbil and Dbil of these two groups were higher than that before surgery.LS group was less than OS group,which had statistically significant(P<0.05).Inflammatory factors and immune function: before the operation,WBC,CRP,CD4+,CD8+,CD4+/CD8+ of LS group and OS group were no statistically significant(P>0.05).1day and 3days after operation,WBC,CRP,CD8+ of these two groups raised and CD4+,CD4+/CD8+ decreased.Endoscope WBC,CPR,CD8+ of LS group were less than OS group.CD4+,CD4+/CD8+ of LS group were higher than OS group.They were statistically significant(P<0.05).Conclusion Compared with OS,LS for hypersplenism secondary to liver cirrhosis has more advantages.Smaller incision during operation,faster incision recover,less postoperation extubation time and postoperative hospital stay time.It can reduce the risk of inflammation effectively.LS is safer and more feasible.LS and OS had the same curative effect but LS operation time is longer than OS's.For the long-term efficacy,the late follow-up is needed for drawing a conclusion. |
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