{"title":"肝硬化脾肿大患者围手术期近端脾动脉栓塞治疗。","authors":"Hidenori Mitani, Keigo Chosa, Shota Kondo, Wataru Fukumoto, Kenji Kajiwara, Rika Yoshimatsu, Tomohiro Matsumoto, Takuji Yamagami, Kazuo Awai","doi":"10.1080/13645706.2023.2275652","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to determine the effect of proximal splenic artery embolization (SAE) in cirrhotic patients with splenomegaly who underwent surgical laparotomy.</p><p><strong>Material and methods: </strong>This retrospective observational study included 8 cirrhotic patients with splenomegaly. They underwent proximal SAE before- (<i>n</i> = 6) or after (<i>n</i> = 2) laparotomy. Vascular plugs or coils were placed in the proximal splenic artery. The diameter of the portal vein and the splenic volume were recorded. Clinical outcome assessments included platelet counts, the model for end-stage liver disease (MELD) score, and complications.</p><p><strong>Results: </strong>After embolization, the portal venous diameter was significantly smaller (pre: 13.6 ± 2.7 mm, post: 12.5 ± 2.3 mm, <i>p</i> = 0.023), the splenic volume was significantly decreased (pre: 463.2 ± 145.7 ml, post: 373.3 ± 108.5 ml, <i>p</i> = 0.008) and the platelet count was significantly higher (pre: 69.6 ± 30.8 × 10<sup>3/</sup>μl, post: 86.8 ± 27.7 × 10<sup>3/</sup>μl, <i>p</i> = 0.035). Before embolization, the median MELD score was 12; after embolization, it was 11 (<i>p</i> = 0.026). No patient developed post-treatment complications after embolization.</p><p><strong>Conclusions: </strong>The reduction of hypersplenism by perioperative proximal SAE may be safe and reduce the surgical risk in cirrhotic patients with splenomegaly.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"35-42"},"PeriodicalIF":1.7000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perioperative proximal splenic artery embolization in cirrhotic patients with splenomegaly.\",\"authors\":\"Hidenori Mitani, Keigo Chosa, Shota Kondo, Wataru Fukumoto, Kenji Kajiwara, Rika Yoshimatsu, Tomohiro Matsumoto, Takuji Yamagami, Kazuo Awai\",\"doi\":\"10.1080/13645706.2023.2275652\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The purpose of this study was to determine the effect of proximal splenic artery embolization (SAE) in cirrhotic patients with splenomegaly who underwent surgical laparotomy.</p><p><strong>Material and methods: </strong>This retrospective observational study included 8 cirrhotic patients with splenomegaly. They underwent proximal SAE before- (<i>n</i> = 6) or after (<i>n</i> = 2) laparotomy. Vascular plugs or coils were placed in the proximal splenic artery. The diameter of the portal vein and the splenic volume were recorded. Clinical outcome assessments included platelet counts, the model for end-stage liver disease (MELD) score, and complications.</p><p><strong>Results: </strong>After embolization, the portal venous diameter was significantly smaller (pre: 13.6 ± 2.7 mm, post: 12.5 ± 2.3 mm, <i>p</i> = 0.023), the splenic volume was significantly decreased (pre: 463.2 ± 145.7 ml, post: 373.3 ± 108.5 ml, <i>p</i> = 0.008) and the platelet count was significantly higher (pre: 69.6 ± 30.8 × 10<sup>3/</sup>μl, post: 86.8 ± 27.7 × 10<sup>3/</sup>μl, <i>p</i> = 0.035). Before embolization, the median MELD score was 12; after embolization, it was 11 (<i>p</i> = 0.026). No patient developed post-treatment complications after embolization.</p><p><strong>Conclusions: </strong>The reduction of hypersplenism by perioperative proximal SAE may be safe and reduce the surgical risk in cirrhotic patients with splenomegaly.</p>\",\"PeriodicalId\":18537,\"journal\":{\"name\":\"Minimally Invasive Therapy & Allied Technologies\",\"volume\":\" \",\"pages\":\"35-42\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Minimally Invasive Therapy & Allied Technologies\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/13645706.2023.2275652\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minimally Invasive Therapy & Allied Technologies","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13645706.2023.2275652","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/2 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Perioperative proximal splenic artery embolization in cirrhotic patients with splenomegaly.
Introduction: The purpose of this study was to determine the effect of proximal splenic artery embolization (SAE) in cirrhotic patients with splenomegaly who underwent surgical laparotomy.
Material and methods: This retrospective observational study included 8 cirrhotic patients with splenomegaly. They underwent proximal SAE before- (n = 6) or after (n = 2) laparotomy. Vascular plugs or coils were placed in the proximal splenic artery. The diameter of the portal vein and the splenic volume were recorded. Clinical outcome assessments included platelet counts, the model for end-stage liver disease (MELD) score, and complications.
Results: After embolization, the portal venous diameter was significantly smaller (pre: 13.6 ± 2.7 mm, post: 12.5 ± 2.3 mm, p = 0.023), the splenic volume was significantly decreased (pre: 463.2 ± 145.7 ml, post: 373.3 ± 108.5 ml, p = 0.008) and the platelet count was significantly higher (pre: 69.6 ± 30.8 × 103/μl, post: 86.8 ± 27.7 × 103/μl, p = 0.035). Before embolization, the median MELD score was 12; after embolization, it was 11 (p = 0.026). No patient developed post-treatment complications after embolization.
Conclusions: The reduction of hypersplenism by perioperative proximal SAE may be safe and reduce the surgical risk in cirrhotic patients with splenomegaly.
期刊介绍：
Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.
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