ABSTRACT
Cross femoro-femoral venous bypass (the Palma operation) is one way of treating iliofemoral venous occlusion in patients with deep vein thrombosis (DVT). We reviewed five patients (four men and one woman, two right legs and three left legs) who underwent the Palma operation. Three patients underwent surgery secondary to severe suprapubic and scrotal varicosities; one patient underwent surgery for symptomatic pain and swelling; and one patient underwent surgery for acute severe DVT. Four patients showed good patency and flow through the venous bypass during follow-up. The suprapubic and scrotal varicosities disappeared after surgery. Our results suggest that the Palma operation is an effective treatment for selected cases of DVT.
Subject(s)
Female , Humans , Male , Femoral Vein , Follow-Up Studies , Leg , Transplants , Varicose Veins , Veins , Venous ThrombosisABSTRACT
PURPOSE: Bleeding from esophago-gastric varices needs urgent treatment. Esophageal varix bleeding usually was controlled by intervention, but rebleeding rate was high. Gastric varix bleeding is unable to be controlled by intervention. Recently, newly developed methods for varix bleeding controll have been used, but surgical intervention is still advocated. We report our experience with esophago-gastric devascularization for bleeding control in portal hypertension and its effectiveness. METHODS: This retrospective study was performed on 32 cases who underwent esophago-gastric devascularization in portal hypertension at Kyuung Hee University Hospital from Nov. 1990 to Feb. 2004. Author analyzed characteristics & patients, causes of portal hypertension, liver function reserve, operation methods, perioperative finding, complications and factors determining postoperative mortality. RESULTS: Sex ratios of male to female was 5.4:1. The ages were ranged from 25 to 70 years old with mean age of 50.5. Postoperative complication rate was 40.6% (13/32) and those were recovered by conservative management. There was one case of recurrent bleeding at 9months postperatively (3%). Mortality rate was 4% in Child-Pugh group A and B, and 57% in group C. The overall mortality rate was 15%. Preoperative hepatic reserve (P<0.05) & preoperative blood pressure (P<0.05) was a significant factors. A mean follow up period is 18.7 months. CONCLUSION: In our study, esophago-gastric devascularization in portal hypertension showed good results with 3% rebleeding rate and 85% overall survival rate. Esophago-gastric devascularization was effective method for esophago-gastric varix bleeding.