Short-term efficacy of splenectomy versus partial splenic embolization for liver cirrhosis and hypersplenism: a Meta-analysis

He HaiGuan; Shen YiNan; Pang ShuJie; Yang Tian; Lu JunHua

doi:10.3969/j.issn.1001-5256.2016.02.021

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Feb. 2016

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Short-term efficacy of splenectomy versus partial splenic embolization for liver cirrhosis and hypersplenism: a Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2016.02.021

The 5th Department of Hepatic Surgery,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University

Research funding:

Received Date: 2015-07-27
Published Date: 2016-02-20

Abstract

Abstract

Objective To systematically evaluate the therapeutic effects of partial splenic embolization( PSE) and splenectomy for liver cirrhosis and hypersplenism. Methods The Medline,Embase,Web of Science,CNKI,Wanfang Data,and VIP were searched to collect the articles on PSE and splenectomy for liver cirrhosis and hypersplenism published between January 1,2005 and May 30,2015. The inclusion of articles was performed by two investigators independently,and after quality assessment and data extraction,Rev Man 5. 3 was applied for the Meta- analysis. Results A total of 10 control studies involving 638 patients were included. The results of the pooled analysis of 4 studies showed that the peripheral platelet counthad a significant difference between the PSE group and the splenectomy group at 1 week after surgery( WMD =- 65. 71,95% CI:- 120. 24 to- 11. 18,P = 0. 02),but showed no significant difference at 1 month after surgery( WMD =0. 68,95% CI:- 8. 16- 9. 52,P = 0. 88). The results of the pooled analysis of 2 studies showed that at 1 month after surgery,the PSE group had a significantly higher number of natural killer cells than the splenectomy group( WMD = 6. 03,95% CI: 3. 80- 8. 26,P < 0. 001),but there was no difference in this number at 1 year after surgery between the two groups( WMD = 3. 60,95% CI: 1. 25- 5. 96,P = 0. 003).The results of the pooled analysis of 3 studies showed that the PSE group had a significantly shorter hospital stay than the splenectomy group( WMD =-2. 52,95% CI:-3. 36 to-1. 67,P <0. 001). Conclusion Compared with the splenectomy group,the short- term increase in platelet count after surgery is alleviated in the PSE group,while there is no significant difference in long- term platelet count; PSE has significant advantages in maintaining the reserve function of immune system,shortening the length of hospital stay,and reducing complications in postoperative patients.
- liver cirrhosis,
- hypersplenism,
- embolization,therapeutic,
- splenectomy,
- Meta-analysis

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References

[1]LIU XL,YANG JQ.Research advances in treatment of hypersplenism[J].J Pract Hepatol,2013,16(4):382-384.(in Chinese)刘雪莲,杨见权.脾功能亢进症治疗进展[J].实用肝脏病杂志,2013,16(4):382-384.

[2]LIBERATI A,ALTMAN DG,TETZLAFF J,et al.The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions:explanation and elaboration[J].J Clin Epidemiol,2009,62(10):e1-e34.

[3]LUO S,LIN Y,ZHANG W.Does simultaneous transurethral resection of bladder tumor and prostate affect the recurrence of bladder tumor?A meta-analysis[J].J Endourol,2011,25(2):291-296.

[4]AMIN MA,EL GENDY MM,DAWOUD IE,et al.Partial splenic embolization versus splenectomy for the management of hypersplenism in cirrhotic patients[J].World J Surg,2009,33(8):1702-1710.

[5]XIN ZL.Effect of portal vein devascularization combined with splenectomy in treatment of cirrhotic portal hypertension[J].Contemp Med Forum,2015,13(3):215-216.(in Chinese)辛忠林.用门脉断流术联合脾脏切除术治疗肝硬化门脉高压症的效果分析[J].当代医药论丛,2015,13(3):215-216.

[6]LIU YS,MA GL,LI D,et al.Interventional treatment of liver cirrhosis with hypersplenism and its therapeutic effect[J].China Foreign Med Treat,2014,8(22):39-40.(in Chinese)刘彦森,马桂玲,李丹,等.肝硬化并脾功能亢进症的介入治疗及疗效分析[J].中外医疗,2014,8(22):39-40.

[7]HAO XY.Short-term therapeutic effect of splenectomy versus splenic artery embolization in treatment of hepatitis B cirrhosis with hypersplenism[J].Seek Med Ask Med,2013,11(7):69-70.(in Chinese)郝向义.脾切除术与脾动脉栓塞术治疗乙肝肝硬化脾功能亢进的近期疗效对比[J].求医问药,2013,11(7):69-70.

[8]JI M,WEN GJ.Effect of PSE on peripheral blood T lymphocyte subsets in patients with liver cirrhosis and hypersplenism[J].Chin Med J Metallurg Industry,2012,29(6):616.(in Chinese)纪民,文国娟.PSE对肝硬化合并脾功能亢进患者外周血中T细胞亚群的影响[J].中国冶金工业医学杂志,2012,29(6):616.

[9]MA LH,ZHOU J,SHI LM,et al.Impact of splenectomy partial splenic embolization on immune function in patients with hepatocellular carcinoma and hypersplenism[J].World Chin J Dig,2010,18(7):669-675.(in Chinese)马立辉,周健,史丽民,等.脾动脉栓塞术对肝癌伴脾亢患者免疫功能的影响[J].世界华人消化杂志,2010,18(7):669-675.

[10]WANG H,OUYANG HP.A comparative study on splenectomy vs partial splenic embolization for hepatic cirrhosis hypersplenism[J].J Clin Surg,2008,16(10):674-675.(in Chinese)王昊,欧阳和平.脾切除术与部分性脾栓塞术治疗肝硬化脾功能亢进的比较研究[J].临床外科杂志,2008,16(10):674-675.

[11]DENG MH,TANG ZF,XU RY,et al.Comparison of effects on treatment of cirrhotic hypersplenism between splenetomy and splenic artery embolization[J].China J Modern Med,2006,16(12):1858-1860,1863.(in Chinese)邓美海,汤照峰,许瑞云,等.脾切除术与脾动脉栓塞术治疗肝硬化脾亢疗效的比较[J].中国现代医学杂志,2006,16(12):1858-1860,1863.

[12]CHEN L,ZHANG YF,ZHANG XH,et al.Evaluate the immediate effect of partial splenic embolization and lienectomy to the liver cirrhosis accompanied with hypersplenism[J].J Clin Hepatol,2005,21(5):284-285.(in Chinese)陈黎,张宇锋,张晓红.部分性脾栓塞术与脾切除术治疗肝硬化脾亢的近期临床评价[J].临床肝胆病杂志,2005,21(5):284-285.

[13]WANG P.Therapeutic effect of splenectomy versus splenic artery embolization in treatment of liver cirrhosis complicated by hypersplenism[J].China Prac Med,2012,7(25):92-93.(in Chinese)王鹏.脾切除术与脾动脉栓塞术治疗肝硬化合并脾亢的疗效对比[J].中国实用医药,2012,7(25):92-93.

[14]HAN MJ,ZHAO ZC,REN K,et al.Application of partial splenic embolization in 30 cases of hepatocellular carcinoma associated with portal hypertension and hypersplenism[J].Chin J Radiol,1996,30(9):39-42.(in Chinese)韩铭钧,赵仲春,任克,等.部分性脾栓塞在肝癌介入治疗中的应用(附30例报告)[J].中华放射学杂志,1996,30(9):39-42.

[15]WANG HB,ZHOU NX,LI ZW,et al.The changes of immunological function in patients with portal hypertension after splenectomy and the contribution of splenic immunological cells[J].J Digest Surg,2004,3(4):286-290.(in Chinese)王洪波,周宁新,李志伟,等.门脉高压症患者脾切除术后免疫功能的改变及其与脾组织免疫细胞的关系[J].消化外科,2004,3(4):286-290.

[16]ZHANG WX,ZHANG BH,ZHANG Y.Shortening average length of stay improve medical efficiency and benefit in hospital[J].Chin Health Economics Mag,2007,26(7):36-37.(in Chinese)张文新,张博恒,张渊.缩短平均住院日有效地提高医院的效率和效益[J].中国卫生经济,2007,26(7):36-37.

[17]AHAN AYFH,ZHANG RX,ZHANG JH,et al.Subtotal splenectomy versus total splenectomy for hepatic cirrhosis and portal hypertension:a systematic review[J].Chin J Evid-based Med,2009,9(6):690-694.(in Chinese)阿依甫汗·阿汗,张日新,张金辉,等.脾大部切除术与脾完全切除术比较治疗肝硬化门脉高压症的系统评价[J].中国循证医学杂志,2009,9(6):690-694.

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Short-term efficacy of splenectomy versus partial splenic embolization for liver cirrhosis and hypersplenism: a Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2016.02.021