Résumé
Objective To study the effectiveness and safety of prophylactic anticoagulation in the prevention of portal venous thrombosis (PVST) in patients after laparoscopic splenectomy.Methods A systematic search of the PubMed,Embase,Cochrane Library,Sinomed,Wangfang,Weipu and CNKI databases was performed to identify studies which compared outcomes in patients with or without prophylactic anticoagulation after laparoscopic splenectomy.The quality of the included studies was assessed using the Cochrane collaboration tool and the Newcastle-Ottawa Scale.Heterogeneity was evaluated using the x2 and I2 tests.The primary outcome was the incidence of postoperative PVST.Results Five studies were included into this review,which involved 206 and 168 patients with or without prophylactic anticoagulation,respectively.The incidence of PVST was significantly reduced with prophylactic anticoagulation with an odds ratio (OR) of 0.32 [95％ confidence interval (CI),0.13 ～0.79,P＜0.05].Conclusion Prophylactic anticoagulation resulted in a significant reduced incidence of PVST after laparoscopic splenectomy.
Résumé
Along with the development of interventional appliances and proficiency of operational skills,the interventional diagnosis and treatment via hepatic portal vein system have achieved great progress and improvement.However,in order to further exploit the advantages of interventional diagnosis and treatment, the review of the anatomical structures,normal aberrance of portal venous system were needed.Getting familiar with pathologic condition to discover the new interventional appliances and embolic agents,and then in term of conduct the research on a very tough substancial base in a down-to-earth manner were important.