دورية أكاديمية
The learning curve of laparoscopic splenectomy and esophagogastric devascularization for portal hypertension with 10-year follow-up.
| العنوان: | The learning curve of laparoscopic splenectomy and esophagogastric devascularization for portal hypertension with 10-year follow-up. |
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| المؤلفون: | Wang D; Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, 569 Xin Si Road, Xi'an, 710038, China., Chen X; Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, 569 Xin Si Road, Xi'an, 710038, China., Lv L; Department of Disease Prevention and Health Care, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China., Yang T; Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, 569 Xin Si Road, Xi'an, 710038, China., Huang B; Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, 569 Xin Si Road, Xi'an, 710038, China., Cao Y; Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, 569 Xin Si Road, Xi'an, 710038, China., Zhang Y; Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, 569 Xin Si Road, Xi'an, 710038, China., Lu J; Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, 569 Xin Si Road, Xi'an, 710038, China., Yin J; Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, 569 Xin Si Road, Xi'an, 710038, China. tdyjk07@fmmu.edu.cn. |
| المصدر: | Surgical endoscopy [Surg Endosc] 2024 Sep; Vol. 38 (9), pp. 5228-5238. Date of Electronic Publication: 2024 Jul 24. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1992- : New York : Springer Original Publication: [Berlin] : Springer International, c1987- |
| مواضيع طبية MeSH: | Learning Curve* , Hypertension, Portal*/surgery , Hypertension, Portal*/complications , Laparoscopy*/methods , Splenectomy*/methods , Esophageal and Gastric Varices*/surgery, Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Follow-Up Studies ; Adult ; Operative Time ; Blood Loss, Surgical/statistics & numerical data ; Gastrointestinal Hemorrhage/surgery ; Gastrointestinal Hemorrhage/etiology ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Esophagus/surgery ; Esophagus/blood supply ; Treatment Outcome ; Aged ; Stomach/blood supply ; Stomach/surgery |
| مستخلص: | Introduction and Objectives: Laparoscopic splenectomy and esophagogastric devascularization (LSED) are minimally invasive, effective, and safe in treating esophageal-fundic variceal bleeding with portal hypertension (PHT). The study aimed to assess the learning curve of LSED by cumulative summation (CUSUM) analysis. The 10-year follow-up data for LSED and open surgery were also examined. Patients and Methods: Five hundred and ninety-four patients were retrospectively analyzed. Operation time, intraoperative blood loss, open operation conversion, and postoperative complications were selected as the evaluation indicators of surgical ability. The learning curve of LESD was assessed by the CUSUM approach. Patient features, perioperative indices, and 10-year follow-up data were examined. Results: Totally 236 patients underwent open surgery, and 358 underwent LSED. Patient characteristics were similar between groups. The LSED patients experienced less intraoperative blood loss, fewer complications, and faster recovery compared to the open surgery cohort. The learning curve of LESD was maximal for a case number of 50. Preoperative general characteristics were comparable for both stages. But the skilled stage had decreased operation time, reduced blood loss, less postoperative complications, and better recovery compared to the learning stage. The LSED group had higher recurrent hemorrhage-free survival rate and increased overall survival in comparison with cases administered open surgery in the 10-year follow-up. Free-liver cancer rates were similar between two groups. Conclusions: About 50 cases are needed to master the LSED procedure. Compared to open surgery, LSED is a safer, feasible, and safe procedure for PHT patients, correlating with decreased rebleeding rate and better overall survival. (© 2024. The Author(s).) |
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| معلومات مُعتمدة: | 81700533 National Natural Science Foundation of China; 2024SF-YBXM-113 Key Science and Technology Program of Shaanxi Province; 2023CTDQN008 Youth Independent Innovation Science Foundation of Tangdu Hospital |
| فهرسة مساهمة: | Keywords: Cumulative summation; Esophagogastric devascularization; Laparoscopic splenectomy; Learning curve; Portal hypertension |
| تواريخ الأحداث: | Date Created: 20240724 Date Completed: 20240830 Latest Revision: 20240924 |
| رمز التحديث: | 20240925 |
| مُعرف محوري في PubMed: | PMC11362247 |
| DOI: | 10.1007/s00464-024-11017-0 |
| PMID: | 39046495 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1432-2218 |
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| DOI: | 10.1007/s00464-024-11017-0 |