ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical effect of fast-track surgery combined with Chinese medicine treatment in devascularization operation for cirrhotic esophageal varices.</p><p><b>METHODS</b>Seventy-two patients with cirrhotic esophageal varices were selected from January 2009 to June 2013, and randomly assigned to a conventional group and a fast-track group (fast-track surgery combined with Chinese medicine treatment) using a randomized digital table, 36 cases in each group. Operation and anesthesia recovery time, postoperative hospitalization and quality of life were recorded and compared between groups during the perioperative period.</p><p><b>RESULTS</b>Compared with the conventional group, the fast-track group had longer operation time (253.6±46.4 min vs. 220.6±51.0 min) and anesthesia recovery time (50.5±15.9 min vs. 23.5±9.6 min; P<0.01); less bleeding (311.3±46.8 mL vs. 356.2±57.5 mL; P<0.01) and less transfusion (1932.3±106.9 mL vs. 2045.6±115.4 mL; P<0.01); as well as faster recovery of gastrointestinal function, shorter postoperative hospitalization and higher quality of life. There were no serious postoperative complications and no further bleeding occurred.</p><p><b>CONCLUSION</b>Fast-track surgery combined with Chinese medicine treatment is a safe and feasible approach to accelerate the recovery of patients with cirrhotic portal hypertension in perioperative period of devascularization operation.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Anesthesia Recovery Period , Blood Loss, Surgical , Blood Transfusion , Chronic Disease , Esophageal and Gastric Varices , General Surgery , Therapeutics , Length of Stay , Liver Cirrhosis , Medicine, Chinese Traditional , Operative Time , Postoperative Complications , Postoperative Period , Quality of Life , SplenectomyABSTRACT
Objective To evaluate the safety and efficacy of hepatectomy in combination with portal azygous disconnection for primary hepatocellular carcinoma (HCC) complicated with severe portal hypertension (PHT). Methods Clinical data of 30 cases of HCC complicated with PHT treated in our hospital from April 2005 to April 2008 were retrospectively analyzed. All 30 cases were randomly divided into the single operation group (group Ⅰ ) and combined group (group Ⅱ ). Results After operation, there were no significant statistical differences in rates of complications such as hepatic encephalopathy, ascites, stress ulcer, etc. and recovery of liver function between the 2 groups. The WBC and PLT counts in the blood samples of group Ⅱ were higher than those in group Ⅰ after operation. The postoperative 1- and 2-year hemorrhagic rates were lower in group Ⅱ than in group Ⅰ .Conclusion Hepatectomy in combination with portal azygous disconnection is safe and feasible for treatment of HCC complicated with PHT.
ABSTRACT
Objective To evaluate the effects of ulinastatin(UTI)on liver and renal function and portal vein thrombosis(PVT)in patients undergoing portal azygous disconnection.Methods Thirty patients undergoing selective portal azygous disconnection were randomly divided into two groups.Group U:UTI 2?105 U was given after anesthesis and followed six days after operation.Group C:The same amount of normal saline instead of UTI.The liver and renal function and PVT were measured.Results There was significant difference in PT%,CHE,ALT at 1st day after operation between two groups,and so was CHE at 5th day and PT%、INR、ALB at 15th day after operation.There was no statistical difference in renal function and PVT between two groups.Conclusions UTI can protect liver function,but no effect on renal function and PVT during portal azygous disconnection.