ABSTRACT
BACKGROUND: In a previous study, autologous bone marrow infusion (ABMI) was performed in patients with decompensated liver cirrhosis (DLC) and acquired immunodeficiency syndrome and achieved good results, but whether splenectomy affected outcome was unclear. AIM: To investigate the efficacy of ABMI combined with splenectomy for treatment of DLC. METHODS: Eighty-three patients with DLC were divided into an intervention group (43 cases) and control group (40 cases) according to whether splenectomy was performed. The control group was treated with ABMI through the right omental vein, and the intervention group was additionally treated with splenectomy. RESULTS: After ABMI, the prothrombin time, serum total bilirubin levels, ascites volume and model for end-stage liver disease score in both groups were significantly lower, while the albumin levels were significantly higher than before ABMI (P < 0.01), but there were no significant differences between the groups (P > 0.05). After ABMI, the white blood cell and platelets counts in both groups were significantly higher than before ABMI (P < 0.01), and the counts in the intervention group were significantly higher than in the control group (P < 0.01). After ABMI the CD4+ and CD8+ T cell counts in both groups were significantly higher than before ABMI (P < 0.01). The CD8+ T cell counts in the intervention group increased continuously and the increase had a shorter duration compared with control group. CONCLUSION: ABMI through the portal vein in patients with DLC can significantly improve liver synthetic and secretory functions, and splenectomy promotes improvement of bone marrow hematopoietic and cellular immune functions.
ABSTRACT
Introduction: For an indirect inguinal hernia (IIH), it is a challenge to repair the internal inguinal ring (IIR) with self-tissue reconstruction in laparoscopic repair. Aim: To evaluate the efficacy and safety of covering the IIR with the lateral umbilical fold (LUF) combined with patch repair in laparoscopic indirect inguinal hernia repair. Material and methods: Patients with IIH treated by trans-abdominal preperitoneal (TAPP) hernia repair at the Department of General Surgery, Shanghai Public Health Clinical Centre between September 2019 and March 2021 were retrospectively analyzed. In group I (n = 57) the LUF was overturned and sutured to cover the IIR under a laparoscope and subsequently repaired with a patch. In group II (n = 62), the IIR was not covered by the LUF but only repaired with a self-gripping mesh. Results: We noted a longer suture time in group I than in group II. Although the LUF was covered after suturing, no significant difference in postoperative pain was observed between the two groups. However, significant differences in surgery time and hospitalization cost (p < 0.05) were found. One case of recurrence was observed in group II. Conclusions: The LUF can be used in IIH to cover the IIR and is a feasible approach. The LUF covering the IIR has no significant difference in pain.
