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Safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices for prehepatic portal hypertension: a pilot study
Zhang, Zhe; Chen, Xueming; Li, Chenyu; Feng, Hai; Yu, Hongzhi; Zhu, Renming; Wang, Tianyou.
  • Zhang, Zhe; Capital Medical University. Beijing Friendship Hospital. Department of Vascular Surgery. Tianjin. CN
  • Chen, Xueming; Capital Medical University. Beijing Friendship Hospital. Department of Vascular Surgery. Tianjin. CN
  • Li, Chenyu; Capital Medical University. Beijing Friendship Hospital. Department of Vascular Surgery. Tianjin. CN
  • Feng, Hai; Capital Medical University. Beijing Friendship Hospital. Department of Vascular Surgery. Tianjin. CN
  • Yu, Hongzhi; Capital Medical University. Beijing Friendship Hospital. Department of Vascular Surgery. Tianjin. CN
  • Zhu, Renming; Capital Medical University. Beijing Friendship Hospital. Department of Vascular Surgery. Tianjin. CN
  • Wang, Tianyou; Capital Medical University. Beijing Friendship Hospital. Department of Thoracic Surgery. Tianjin. CN
Clinics ; 74: e704, 2019. tab, graf
Article in English | LILACS | ID: biblio-1019706
ABSTRACT

OBJECTIVES:

This pilot study investigated the safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices in patients with prehepatic portal hypertension.

METHODS:

Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into three groups by surgery type shunt surgery alone (Group A), shunt surgery and devascularization (Group B), and shunt surgery combined with foam sclerotherapy (Group C). Between-group differences in operation time, intraoperative blood loss, portal pressure decrease, postoperative complications, rebleeding rates, encephalopathy, mortality rates and remission of gastroesophageal varices were compared.

RESULTS:

Groups A, B and C had similar operation times, intraoperative bleeding, and portal pressure decrease. The remission rates of varices differed significantly (p<0.001) one patient in Group A and 6 patients in Group B had partial response, and all 9 patients in Group C had remission (2 complete, 7 partial). Two Group A patients and one Group B patient developed recurrent gastrointestinal bleeding postoperatively within 12 months. No postoperative recurrence or bleeding was observed in Group C, and no sclerotherapy-related complications were observed.

CONCLUSIONS:

Shunt surgery combined with foam sclerotherapy obliterates varices more effectively than shunt surgery alone does, decreasing the risk of postoperative rebleeding from residual gastroesophageal varices. This novel surgery is safe and effective with good short-term outcomes.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Esophageal and Gastric Varices / Sclerotherapy / Hypertension, Portal Type of study: Etiology study / Observational study / Risk factors Limits: Adolescent / Adult / Child / Female / Humans / Male Language: English Journal: Clinics Journal subject: Medicine Year: 2019 Type: Article Affiliation country: China Institution/Affiliation country: Capital Medical University/CN

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Full text: Available Index: LILACS (Americas) Main subject: Esophageal and Gastric Varices / Sclerotherapy / Hypertension, Portal Type of study: Etiology study / Observational study / Risk factors Limits: Adolescent / Adult / Child / Female / Humans / Male Language: English Journal: Clinics Journal subject: Medicine Year: 2019 Type: Article Affiliation country: China Institution/Affiliation country: Capital Medical University/CN