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1.
Chinese Journal of Hepatology ; (12): 90-95, 2023.
Artículo en Chino | WPRIM | ID: wpr-970957

RESUMEN

Objective: To compare the safety and efficacy of transmesenteric vein extrahepatic portosystemic shunt (TEPS) and transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of cavernous transformation of the portal vein (CTPV). Methods: The clinical data of CTPV patients with patency or partial patency of the superior mesenteric vein treated with TIPS or TEPS treatment in the Department of Vascular Surgery of Henan Provincial People's Hospital from January 2019 to December 2021 were selected. The differences in baseline data, surgical success rate, complication rate, incidence rate of hepatic encephalopathy, and other related indicators between TIPS and TEPS group were statistically analyzed by independent sample t-test, Mann-Whitney U test, and Chi-square test. Kaplan-Meier survival curve was used to calculate the cumulative patency rate of the shunt and the recurrence rate of postoperative portal hypertension symptoms in both groups. Results: The surgical success rate (100% vs. 65.52%), surgical complication rate (6.67% vs. 36.84%), cumulative shunt patency rate (100% vs. 70.70%), and cumulative symptom recurrence rate (0% vs. 25.71%) of the TEPS group and TIPS group were statistically significantly different (P < 0.05). The time of establishing the shunt [28 (2141) min vs. 82 (51206) min], the number of stents used [1 (12) vs. 2 (15)], and the length of the shunt [10 (912) cm vs. 16 (1220) cm] were statistically significant between the two groups (t = -3.764, -4.059, -1.765, P < 0.05). The incidence of postoperative hepatic encephalopathy in the TEPS group and TIPS group was 6.67% and 15.79% respectively, with no statistically significant difference (Fisher's exact probability method, P = 0.613). The pressure of superior mesenteric vein decreased from (29.33 ± 1.99) mmHg to (14.60 ± 2.80) mmHg in the TEPS group and from (29.68 ± 2.31) mmHg to (15.79 ± 3.01) mmHg in TIPS group after surgery, and the difference was statistically significant (t = 16.625, 15.959, P < 0.01). Conclusion: The best indication of TEPS is in CTPV patients with patency or partial patency of the superior mesenteric vein. TEPS improves the accuracy and success rate of surgery and reduces the incidence of complications.


Asunto(s)
Humanos , Vena Porta/cirugía , Derivación Portosistémica Intrahepática Transyugular/métodos , Encefalopatía Hepática/etiología , Resultado del Tratamiento , Hipertensión Portal/complicaciones , Estudios Retrospectivos , Hemorragia Gastrointestinal/etiología
2.
Pakistan Journal of Medical Sciences. 2016; 32 (1): 13-17
en Inglés | IMEMR | ID: emr-178566

RESUMEN

Objective: To evaluate the therapeutic effects of endovascular aneurysm repair [EVAR] on abdominal aortic aneurysm [AAA] complicated with hypertension


Methods: Fifty-two patients with AAA complicated with hypertension treated in our hospital were retrospectively analyzed. They were divided into an observation group [34 cases] and a control group [18 cases]. The control group was treated by incision of AAA and artificial blood vessel replacement, and the observation group was treated by EVAR


Results: All surgeries were performed successfully. However, compared with the control group, the observation group had significantly less surgical time, intraoperative blood loss and blood transfusion, as well as significantly higher total hospitalization expense [P<0.05]. During the one-month follow-up, the observation group was significantly less prone to pulmonary infection, surgical site infection, lowerextremity deep venous thrombosis and lower extremity weakness than the control group [P<0.05]. The observation group enjoyed significantly better quality of life than the control group did one and three months after surgery [P<0.05]


Conclusion: Given sufficient funding, EVAR should be preferentially selected in the treatment of AAA complicated with hypertension due to minimal invasion, safety, stable postoperative vital signs and improved quality of life

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