ABSTRACT
Objective To evaluate a modified Suguira procedure for the treatment of variceal bleeding.Methods A modified Suguira procedure was performed in 62 patients with acute variceal bleeding (11 cases) that could not be controlled by endoscopic therapy or with a history of massive bleeding (51 cases) after endoscopic therapy.Results Perioperative mortality occurred in 2％ (1/62) patients.Esophageal anastomotic leak occurred in 2％ (1/62) patients,and anastomotic stenosis developed in 5％ (3/62) patients.Twelve months after operation,esophageal varices disappeared in 79％ (48/61) patients,diminished in size in 18％ (11/61),remained unchanged in 3％ (2/61) ; Fundal gastric varices disappeared in 98％ (60/61) patients,diminished in size in 2％ (1/62).The rebleeding rate was 3％ (2/61) and 8％ (5/61) in 3 years and 5 years,respectively.Conclusions The modified Suguira procedure is safe and effective for long-term control of variceal bleeding after a failed endoscopic therapy.
ABSTRACT
Objective Acute esophageal variceal bleeding is one of the most dreadful complications of cirrhotic portal hypertension.This study evaluated a modified gastro-esophageal decongestion (MGED) procedure in the management of acute variceal bleeding that could not be controlled by drugs and/or endoscopic therapy.Methods A MGED procedure was performed in 136 patients with uncontrollable acute variceal bleeding by drugs and/or endoscopic therapy.The perioperative and long-term outcome of these patients were retrospectively studied.Resluts Immediate control of variceal bleeding was achived in 97.8％ (133/136) patients.Perioperative mortality occurred in 5.1％ (7/136) patients.The 3-year and 5-year rebleed rate was 7.0％ (9/129) and 13.2％,respectively.The 3-year and 5-year overall survival rate was 91.5％ (118/129) and 79.8％ (103/129),respectively.Conclusions In this study,the MGED procedure was an effective life-saving procedure in controlling acute esophageal variceal bleeding for its safe,simple and less time-consuming advantages.
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Objective To evaluate the effects of esophagogastroplasty of esophagogastrostomy in preventing anastomotic leakage,stricture and reflux esophagitis after resection of lower esophageal or cardiac carcinoma.Methods 273 cases of lower esophageal cardiac carcinoma were randomly divided into 2 groups:The treatment group(145 cases) was treated by esophagogastrostomy encircled by sero muscular gastric wall flap while the control group(128 cases) was performed with esophagogastrostomy only.Results No anastomotic leakage or stricture was observed in treatment group,with 10 cases of reflux esophgitis only.In control group,anastomotic leakage,stricture and reflux esophagitis were 9(7 0%),5(3 9%),and 21(17 1%) respectively.Conclusions The esophagogastroplasty of esophagogastrostomy can completely avoid anastomotic leakage,stricture and significantly reduce reflux esophagitis after resection of lower esophageal or cardiac carcinoma.
ABSTRACT
Objective To evaluate the therapeutic effects of EN,PN support on postoperative recovery of (patients) with portal hypertension. Methods 135 patients with portal hypertension who underwent (esophagogastric) devasularization were randomly divided into three groups:EN,PN and control group. (Postoperatively), EN and PN nutritional support and routine fluid replacement therapy was respectively given to the 3 groups. Several clinical and laboratory parameters were studied in order to determine the therapeutic effect of the two different forms of nutrition.Results Nutritional status and immunological function of patients were improved in both EN and PN study groups but with no significant difference, while alterations in liver function and incidence of abdominal infection were higher in PN group. Conclusions EN is an optimal form of nutritional support for patients with portal hypertension after operation.