Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 2 Date: 04 Sep 2024
Reviewer's report:
This is a retrospective study to evaluate the efficacy of laparoscopic splenectomy plus
esophagogastric devascularization (LSED) for treating portal hypertension (PHT). The authors
showed a significant decreased hepatic venous pressure gradient (HVPG), and patients with
postoperative HVPG decreased > 20% obtained better upper gastrointestinal bleeding (UGIB)-
free survival. However, the following concerns need to be addressed:
Major comments
1. On line 2 in Page 4, 135 patients were finally included into the study. Could the authors show
how many patients underwent LSED during the study period in total? It would be better to add
the consort diagram for the retrospective study.
2. On lines 20-21 in Page 4, the authors described that the spleen was transected with an Endo
GIA stapler. Precisely saying, “spleen” should be replaced with “splenic hilum”.
3. On lines 5-8 in Page 10 and Table 5, the authors analyzed the prognostic factor for
postoperative UGIB. However, the model was unstable and the range of CI was too large,
since the UGIB events had occurred in only 9 of 57 patients.  It would be better to delete the
multivariate analysis.
4. As for the analysis of UGIB-free survival in Figure 5, was the death of the patient included into
the event? For this type of analysis, the event of death can be a competing risk. In Figure 5, what
did the spot in the graph mean? Could the authors please add patients at risk under the graph?
Minor comment
5. On line 18 in Page 2, the word “always” should be replaced.
6. On line 14 in Table 3, the font type of “6.21” was not consistent to the other parts.
Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 2 Date: 04 Sep 2024
Reviewer's report:
This is a retrospective study to evaluate the efficacy of laparoscopic splenectomy plus
esophagogastric devascularization (LSED) for treating portal hypertension (PHT). The authors
showed a significant decreased hepatic venous pressure gradient (HVPG), and patients with
postoperative HVPG decreased > 20% obtained better upper gastrointestinal bleeding (UGIB)-
free survival. However, the following concerns need to be addressed:
Major comments
1. On line 2 in Page 4, 135 patients were finally included into the study. Could the authors show
how many patients underwent LSED during the study period in total? It would be better to add
the consort diagram for the retrospective study.
2. On lines 20-21 in Page 4, the authors described that the spleen was transected with an Endo
GIA stapler. Precisely saying, “spleen” should be replaced with “splenic hilum”.
3. On lines 5-8 in Page 10 and Table 5, the authors analyzed the prognostic factor for
postoperative UGIB. However, the model was unstable and the range of CI was too large,
since the UGIB events had occurred in only 9 of 57 patients.  It would be better to delete the
multivariate analysis.
4. As for the analysis of UGIB-free survival in Figure 5, was the death of the patient included into
the event? For this type of analysis, the event of death can be a competing risk. In Figure 5, what
did the spot in the graph mean? Could the authors please add patients at risk under the graph?
Minor comment
5. On line 18 in Page 2, the word “always” should be replaced.
6. On line 14 in Table 3, the font type of “6.21” was not consistent to the other parts.
Please review this paper.
user
Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 2 Date: 04 Sep 2024
Reviewer's report:
This is a retrospective study to evaluate the efficacy of laparoscopic splenectomy plus
esophagogastric devascularization (LSED) for treating portal hypertension (PHT). The authors
showed a significant decreased hepatic venous pressure gradient (HVPG), and patients with
postoperative HVPG decreased > 20% obtained better upper gastrointestinal bleeding (UGIB)-
free survival. However, the following concerns need to be addressed:
Major comments
1. On line 2 in Page 4, 135 patients were finally included into the study. Could the authors show
how many patients underwent LSED during the study period in total? It would be better to add
the consort diagram for the retrospective study.
2. On lines 20-21 in Page 4, the authors described that the spleen was transected with an Endo
GIA stapler. Precisely saying, “spleen” should be replaced with “splenic hilum”.
3. On lines 5-8 in Page 10 and Table 5, the authors analyzed the prognostic factor for
postoperative UGIB. However, the model was unstable and the range of CI was too large,
since the UGIB events had occurred in only 9 of 57 patients.  It would be better to delete the
multivariate analysis.
4. As for the analysis of UGIB-free survival in Figure 5, was the death of the patient included into
the event? For this type of analysis, the event of death can be a competing risk. In Figure 5, what
did the spot in the graph mean? Could the authors please add patients at risk under the graph?
Minor comment
5. On line 18 in Page 2, the word “always” should be replaced.
6. On line 14 in Table 3, the font type of “6.21” was not consistent to the other parts.
assistant