Abstract:
Objective To investigate the effects of modified splenopneumopexy combined with autologous peripheral blood stem cell transplantation (APBSCT) on variceal bleeding of portal hypertension.
Methods The clinical data of patients with variceal bleeding of portal hypertension who were admitted to the First Affiliated Hospital of Zhengzhou University between March 2010 and December 2014 were collected. Thirty-one patients who underwent modified splenopneumopexy were set as control group, and 17 of modified splenopneumopexy combined with APBSCT therapy were set as trial group. The levels of aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB) 3 months and 6 months after operation, the formation of collateral circulation between spleen and lung 3 months after operation were compared between the two groups. The difference of re-bleeding time between the two groups was analyzed by Kaplan-Meier survival curve and Log-rank test.
Results There were no significant differences in serum AST, TBIL between the two groups at 3rd month and 6th month after operation. However, serum ALB in the trial group was significantly higher than the control group concurrently, with significant differences (t=-2.399, 2.152; P=0.021, 0.037). Eleven patients in the control group didn't have obvious collateral circulation at the 3rd month after operation, the collateral circulation unformed rate was 35.48% (11/31), significantly higher than the trial group (5.88%, 1/17), the difference was statistically significant (χ2=5.131, P=0.024). One patient in the trial group showed re-bleeding of the digestive tract at the 12th month after surgery, while 10 patients re-bled in the control group, 3 of which happened within 3 months after surgery, the difference of re-bleeding time between the two groups was statistically significant (χ2=4.362, P=0.037).
Conclusion APBSCT can promote the establishment of collateral circulation between the spleen and the lung after modified splenopneumopexy, reduce the risk of rebleeding and improve the liver synthesis function, which deserves further application.
Key words:
Portal hypertension,
Stem cell transplantation,
Splenopneumopexy,
Upper gastrointestinal bleeding,
Collateral circulation
Xiaowei Dang, Lin Li, Luhao Li, Kunkun Fu, Song Li, Guanghui Niu, Zhongjie Zhang. Effects of modified splenopneumopexy combined with autologous peripheral blood stem cell transplantation on variceal bleeding of portal hypertension[J]. Chinese Archives of General Surgery(Electronic Edition), 2018, 12(06): 384-387.