Abstract：
BACKGROUND: The prognosis comparison between endoscopic therapy + partial splenic embolization (PSE) and Hassab\'s operation is unclear in the treatment of esophageal variceal bleeding in patients with liver cirrhosis. This study aimed to compare the outcome of endoscopic therapy + PSE (EP) with a combination of splenectomy + pericardial devascularization procedure, known as Hassab\'s operation (SH) for esophageal variceal bleeding in patients with liver cirrhosis with hypersplenism.
METHODS: We enrolled 328 patients, including 125 and 203 patients who underwent EP and SH, respectively. Each group consisted of 110 patients after propensity score matching (PSM). Subsequently, we recorded and analyzed bleeding episodes and mortality in 6 months and 1, 2, and 5 years after therapies.
RESULTS: The median follow-up time in the EP and SH groups was 53 and 64 months, respectively. Bleeding incidence 6 months after therapies in the EP group was lower than that in the SH group (1.8% vs. 10.0%, P = 0.010). Additionally, complications in the perioperative period were not significantly different (0% vs. 3.6%, P = 0.008). However, the bleeding rate between the two groups was not significantly different at 1, 2, and 5 years after therapies (7.3% vs. 12.7%, P = 0.157; 10.9% vs. 16.4%, P = 0.205; 30.6% vs. 31.8%, P = 0.801), as well as mortality rate (4.5% vs 7.3%, P = 0.571).
CONCLUSIONS: Compared with SH therapy, the bleeding rate 6 months after EP therapy was lower, but the long-term bleeding rate was similar.
METHODS: We enrolled 328 patients, including 125 and 203 patients who underwent EP and SH, respectively. Each group consisted of 110 patients after propensity score matching (PSM). Subsequently, we recorded and analyzed bleeding episodes and mortality in 6 months and 1, 2, and 5 years after therapies.
RESULTS: The median follow-up time in the EP and SH groups was 53 and 64 months, respectively. Bleeding incidence 6 months after therapies in the EP group was lower than that in the SH group (1.8% vs. 10.0%, P = 0.010). Additionally, complications in the perioperative period were not significantly different (0% vs. 3.6%, P = 0.008). However, the bleeding rate between the two groups was not significantly different at 1, 2, and 5 years after therapies (7.3% vs. 12.7%, P = 0.157; 10.9% vs. 16.4%, P = 0.205; 30.6% vs. 31.8%, P = 0.801), as well as mortality rate (4.5% vs 7.3%, P = 0.571).
CONCLUSIONS: Compared with SH therapy, the bleeding rate 6 months after EP therapy was lower, but the long-term bleeding rate was similar.
摘要：
背景：内镜治疗+部分脾栓塞术（PSE）与Hassab手术治疗肝硬化食管静脉曲张破裂出血的预后比较尚不清楚。本研究旨在比较内镜治疗+PSE(EP)与脾切除+心包血管离断术联合治疗的结果。称为Hassab手术（SH），用于肝硬化脾功能亢进患者的食管静脉曲张破裂出血。
方法：我们招募了328名患者，包括125和203例接受EP和SH的患者，分别。每组由110例倾向评分匹配（PSM）后的患者组成。随后，我们记录并分析了治疗后6个月和1,2和5年的出血事件和死亡率.
结果：EP组和SH组的中位随访时间分别为53和64个月，分别。EP组治疗后6个月出血发生率低于SH组（1.8%vs.10.0%,P=0.010)。此外,围手术期并发症无显著差异(0%vs.3.6%,P=0.008)。然而,治疗后1、2和5年，两组之间的出血率没有显着差异（7.3％vs.12.7%,P=0.157；10.9%vs.16.4%,P=0.205；30.6%vs.31.8%,P=0.801),以及死亡率(4.5%和7.3%，P=0.571)。
结论：与SH治疗相比，EP治疗后6个月出血率较低，但长期出血率相似。
方法：我们招募了328名患者，包括125和203例接受EP和SH的患者，分别。每组由110例倾向评分匹配（PSM）后的患者组成。随后，我们记录并分析了治疗后6个月和1,2和5年的出血事件和死亡率.
结果：EP组和SH组的中位随访时间分别为53和64个月，分别。EP组治疗后6个月出血发生率低于SH组（1.8%vs.10.0%,P=0.010)。此外,围手术期并发症无显著差异(0%vs.3.6%,P=0.008)。然而,治疗后1、2和5年，两组之间的出血率没有显着差异（7.3％vs.12.7%,P=0.157；10.9%vs.16.4%,P=0.205；30.6%vs.31.8%,P=0.801),以及死亡率(4.5%和7.3%，P=0.571)。
结论：与SH治疗相比，EP治疗后6个月出血率较低，但长期出血率相似。
