Collateral circulation development and its influence between spleen and lung in patients after modified splenopneumopexy / 中华普通外科杂志

ABSTRACT

Objective To investigate the development and influence factors of collateral circulation between spleen and lung in patients with portal hypertension after modified splenopneumopexy.Methods Data of 59 patients from January 2009 to December 2014 were analyzed,and the development of collateral circulation between spleen and lung after surgery were evaluated with ultrasound.Patients were divided into obvious collaterals group (maximum collateral diameter ≥ 2 mm,n =43) and non-obvious collaterals group (maximum collateral diameter ＜ 2 mm,n =16) according to ultrasound examination 3 months after surgery.Gender,age,type of disease,Child-Pugh classification,free portal pressure,portal vein diameter,splenic vein diameter,splenic artery diameter,splenic length,ejection fraction,forced vital capacity rate of one second (FEV1％),whether partial splenectomy was performed,and management of splenic upper pole were recorded and analyzed between the two groups.Results 3 months after surgery obvious collateral circulation could be observed in 43 patients,6 months after surgery the number increased to 53 (x2 =4.526,P ＜ 0.05).Splenic length (t =2.092) and FEV1％ (t =2.233) were significantly higher in obvious collaterals group (all P ＜ 0.05),and there were no statistical differences in gender (x2 =0.092),age (t =-1.254),type of disease (x2 =1.565),Child-Pugh classification (Z =-1.821),free portal pressur (t =0.912),portal vein diameter (t =0.008),splenic vein diameter (t =-0.485),splenic artery diameter (t =0.397),ejection fraction (t =-0.852),whether partial splenectomy was performed (x2 =0.002),and management of splenic upper pole (x2 =1.731) between the two groups (all P ＞ 0.05).Conclusions Obvious collateral circulation can develop between spleen and lung in patients with portal hypertension after modified splenopneumopexy,and the development of collateral circulation is associated with splenic length and FEV1％.