ABSTRACT
Objective@#To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension.@*Methods@#There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People′s Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting.@*Results@#Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients′ long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%.@*Conclusions@#Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient′s short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.
ABSTRACT
Tumor recurrence is the main factor affecting the postoperative prognosis of hepatocellular carcinoma.The forecast of tumor recurrence by monitoring biomarker can effectively improve the prognosis of such disease.To improve the detection rate of early cancer recurrence can be achieved by detecting the level of the alpha-fetoprotein (AFP),Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3),des-γ-carboxyprothrombin (DCP),or combined detection.In recent years,the researches on the miRNA and Long Noncoding RNAs (LncRNA),which are key regulators in the upstream of signal pathways,could provide a new way for HCC recurrence monitoring.The combined detection of biomarkers in different control levels,maybe is the effective measure to improve the tumor recurrence detection rate,and is also the focus of the further research.