Pharmacologic Prophylaxis of Portal Venous System Thrombosis after Splenectomy: A Meta-Analysis

Table 1

Characteristics of included studies.

First author and Journal (year)	Regions	Enrollment period	Study design	Study population	Surgery	Number of patients
Kakinoki Surg Today (2013) Full-text [17]	Kagawa, Japan	February 2008–April 2011	Prospective	Consecutive patients with LC and hypersplenism. Detailed indications were as follows: a bleeding tendency (), induction of interferon therapy (), difficulties in therapies for HCC due to thrombocytopenia (), and esophagogastric varices ().	Hand-assisted laparoscopic splenectomy	28
Kawanaka Ann Surg (2010) Full-text [18]	Fukuoka, Japan	January 2005–December 2005 (1st period); January 2006–July 2006 (2nd period)	2-period, prospective cohort study	Consecutive patients with LC and hypersplenism. Detailed indications were as follows: bleeding tendency due to thrombocytopenia (), difficulties in the induction or continuation of pegylated interferon therapy plus ribavirin due to thrombocytopenia (), difficulties with therapies for HCC due to thrombocytopenia (), and endoscopic treatment-resistant esophagogastric varices ().	Laparoscopic splenectomy	50
Lai World J Gastroenterol (2012) Full-text [19]	Beijing, China	April 2004–July 2010	Retrospective	Patients with PH, splenomegaly, and hypersplenism. Detailed indications were as follows: hypersplenism and recurrent upper GI bleeding (236 patients had a history of upper GI bleeding).	Splenectomy with gastroesophageal devascularization	301
Ma Zhonghua Yi Xue Za Zhi (2008) Full-text [20]	Xi’an, China	July 2004–August 2005	RCT	Patients with LC and PH.	Splenectomy and pericardial devascularization	76
Pan J Gastroenterol Hepatol (2011) Abstract [21]	Guangzhou, China	March 1999–June 2005	Retrospective	Patients with PH in LC from hepatitis.	Simple splenectomy, splenectomy and EVL, splenectomy and porta-azygous devascularization	112
Svensson Eur J Haematol (2006) Full-text [22]	Stockholm, Sweden	January 1999–December 2003	Retrospective	Adult patients, age ≧20 yr, who underwent splenectomy for haematological disorders.	Laparoscopic splenectomy (); open splenectomy ()	69
Wang Can J Surg (2011) Full-text [23]	Alberta, Canada	November 2006–November 2008	2-centre, phase II, prospective, open-label, parallel-assignment RCT	No detailed information regarding eligible patients. Patients requiring splenectomy due to various causes (hematological diseases).	Laparoscopic splenectomy	29*
Xue Zhonghua Wai Ke Za Zhi (2000) Full-text [24]	Zhengzhou, China	June 1995–June 1999	RCT	HBV-related LC patients with PH, upper GI bleeding, splenomegaly, and hypersplenism.	Splenectomy with porta-azygous devascularization	71

Notes: *35 participants were enrolled in this RCT. But 6 participants were excluded, because 4 withdrew from the study, 1 required conversion to an open approach, and 1 died at 3 postoperative months from myocardial infarction that was unrelated to the procedure or study medication.
Abbreviations: EVL: endoscopic variceal ligation; GI: gastrointestinal; HBV: hepatitis B virus; LC: liver cirrhosis; PH: portal hypertension; and RCT: randomized controlled trial.