Clinical application of fast-track surgery with Chinese medicine treatment in the devascularization operation for cirrhotic portal hypertension

Chin J Integr Med. 2015 Oct;21(10):784-90. doi: 10.1007/s11655-015-2317-9. Epub 2015 Nov 3.

Abstract

Objective: To investigate the clinical effect of fast-track surgery combined with Chinese medicine treatment in devascularization operation for cirrhotic esophageal varices.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Chinese medicine treatment; cirrhotic esophageal varices; fast-track surgery; portal-azygous disconnection; splenectomy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anesthesia Recovery Period
  • Blood Loss, Surgical
  • Blood Transfusion
  • Chronic Disease
  • Esophageal and Gastric Varices / surgery
  • Esophageal and Gastric Varices / therapy*
  • Female
  • Humans
  • Length of Stay
  • Liver Cirrhosis / complications*
  • Male
  • Medicine, Chinese Traditional*
  • Middle Aged
  • Operative Time
  • Postoperative Complications
  • Postoperative Period
  • Quality of Life
  • Splenectomy