Modified laparoscopic splenectomy and azygoportal disconnection combined with cell salvage is feasible and might reduce the need for blood transfusion

Table 1 Patients’ demographic and clinical characteristics

Variable	Group A (n = 46)	Group B (n = 33)	P value
Sex
Male	29	16	0.197
Female	17	17
Age (yr)	54.67 ± 10.52	52.55 ± 9.76	0.364
Etiology
HBV cirrhosis	23	21	0.229
HCV cirrhosis	3	3	1.000
Schistosoma cirrhosis	6	1	0.253
Alcoholic cirrhosis	3	0	0.369
Autoimmunity liver cirrhosis	9	5	0.612
Cryptogenic	2	3	0.700
Child-Pugh classification			0.479
A	30	24
B	16	9
Longitudinal diameter of spleen (cm)	18.03 ± 2.97	19.16 ± 2.95	0.101
Spleen volume index (cm3)	1599.88 ± 791.84	1763.89 ± 715.56	0.348

Group A: Allogeneic blood transfusion group; Group B: Cell salvage and autologous blood transfusion group. HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 2 Intraoperative and postoperative data

Variable	Group A (n = 46)	Group B (n = 33)	P value
Operative time (min)	220.98 ± 56.92	208.79 ± 54.24	0.341
Estimated blood loss (mL)	179.35 ± 157.96	158.18 ± 220.35	0.620
Volume of blood transfusion (n)	2	0	0.626
VAS score of the first day	2.50 ± 0.84	2.73 ± 0.91	0.255
First oral intake time after operation (d)	1.46 ± 0.62	1.33 ± 0.60	0.380
Initial passage of flatus time (d)	2.43 ± 0.91	2.58 ± 0.90	0.498
Postoperative off-bed activity time (d)	2.57 ± 0.69	2.39 ± 0.66	0.270
Postoperative hospital stay (d)	10.72 ± 2.62	11.30 ± 2.32	0.308
Perioperative complications	6	4	1.000
Asymptomatic portal vein thrombosis	5	3	1.000
Pancreatic fistula	1	1	1.000
Incision complications	0	0
Pneumonia	0	0
Abdominal infection	0	0
Emergency operation for bleeding	0	0

Group A: Allogeneic blood transfusion group; Group B: Cell salvage and autologous blood transfusion group. VAS: Visual analog scale for pain.

Table 3 Inflammatory response data

Variable	Group A (n = 46)	Group B (n = 33)	P value
Postoperative subfebrile (T > 38.0 °C) days	3.67 ± 2.92	2.33 ± 2.91	0.047
No fever, n	7	11	0.058
WBC day 0, 109/L	3.03 ± 1.85	2.35 ± 1.39	0.082
WBC day 1, 109/L	11.33 ± 3.50	10.97 ± 3.61	0.654
WBC day 3, 109/L	11.25 ± 3.61	11.89 ± 4.09	0.464
WBC day 7, 109/L	8.73 ± 2.56	9.33 ± 3.83	0.400

Group A: Allogeneic blood transfusion group; Group B: Cell salvage and autologous blood transfusion group; Postoperative subfebrile temperature: Number of postoperative days on which body temperature exceeded 38.0 °C; day 0: Day of admission; day 1: Postoperative day 1; day 3: Postoperative day 3; day 7: Postoperative day 7.

Table 4 Postoperative hepatic and renal function

Variable	Group A (n = 46)	Group B (n = 33)	P value
ALT day 0, U/L	30.98 ± 23.33	29.64 ± 15.21	0.773
ALT day 1, U/L	37.52 ± 18.47	33.27 ± 15.80	0.228
ALT day 3, U/L	29.78 ± 23.27	31.97 ± 40.12	0.761
ALT day 7, U/L	20.67 ± 11.73	21.52 ± 13.59	0.769
Creatinine day 0, umol/L	72.35 ± 17.63	71.33 ± 16.83	0.797
Creatinine day 1, umol/L	75.58 ± 16.37	73.18 ± 23.00	0.589
Creatinine day 3, umol/L	60.15 ± 16.25	60.97 ± 20.53	0.843
Creatinine day 7, umol/L	61.19 ± 14.54	60.52 ± 16.03	0.846

Group A: Allogeneic blood transfusion group; Group B: Cell salvage and autologous blood transfusion group; day 0: Day of admission; day 1: Postoperative day 1; day 3: Postoperative day 3; day 7: Postoperative day 7.