Comparison of two laparoscopic splenectomy plus pericardial devascularization techniques for management of portal XXXX and @entity6118 .

@entity1 @entity1733 @entity101 @entity190 @entity1578 @entity3472 @entity86 @entity6118 @entity715 @entity360
OBJECTIVE: Our research was conducted to analyze the outcomes of two laparoscopic splenectomy plus pericardial devascularization (LSPD) techniques in the management of portal @entity101 (PTH) and @entity6118 . METHODS: Between May 2012 and May 2013, 41 @entity1 with PTH and @entity6118 undergoing LSPD were retrospectively analyzed. Of them, 29 @entity1 received LSPD by LigaSure    Vessel Sealing System (LVSS) and Endo-GIA    universal endoscopic vascular linear staplers (Endo-GIA) (EG Group) and 12 @entity1 received LSPD by LVSS and Hem-o-Lock ( @entity1733 Group). Operating time, intraoperative @entity190 , postoperative course, and hospitalization costs were compared between the two LSPD combination techniques. RESULTS: There were no significant differences in preoperative @entity1 characteristics of the two groups. Significantly less operating time, intraoperative @entity86 were observed in EG Group. The incidence of @entity715 was lower in the EG Group (3.4 vs. 8.3  %), as well as the incidence of @entity3472 (0 vs. 8.3  %). @entity360 was not observed in either group. Uncontrolled bleeding warranted conversion to open surgery in one case in EG Group (conversion rate 3.4  %) and in two cases in @entity1733 Group (conversion rate 16.7  %). Two @entity1 (16.7  %) in @entity1733 Group underwent successful emergency exploratory laparotomy due to uncontrolled intraabdominal bleeding postoperatively. No re-operation was needed in EG Group. Two @entity1 experienced @entity1578 after surgery in each group. Of those, three @entity1 were managed successfully and one @entity1 refused further therapy. While the overall complication rate was significantly lower in EG Group (17.2 vs. 58.3  %, P  <  0.05), overall hospitalization costs remained significantly higher for EG Group. CONCLUSION: The results suggest that the modified Endo-GIA and LVSS technique is a safe and effective combination approach to LSPD with shorter operative time, less intraoperative @entity190 , lower conversion rate to laparotomy, shorter hospital stay, better recovery, and lower postoperative complication rate compared with the Hem-o-Lock and LVSS approach. Higher hospitalization expenses associated with the Endo-GIA and LVSS approach.
