Transabdominal gastroesophageal devascularization without esophageal transection for emergency treatment of variceal hemorrhage.
Artigo
em Inglês
| IMSEAR
| ID: sea-64334
ABSTRACT
BACKGROUND:
The Suguira procedure is an effective non-shunting operation to treat life-threatening hemorrhage from esophageal or gastric varices. The goal of esophageal transection is interruption of submucosal varices, but this leads to high morbidity and mortality rates from esophageal fistulization.AIM:
To evaluate a variant of this procedure in which the esophagus is not transected, but the varices are underrun from outside the lumen.METHODS:
During the last four and a half years, we performed this modified gastroesophageal devascularization with or without splenectomy in 18 patients as emergency treatment of bleeding esophageal and gastric varices. The data were analyzed retrospectively.RESULTS:
Bleeding was controlled in all patients. Three patients with Child's class C disease undergoing emergency surgery died during the early postoperative period. Rebleeding rate was 17% (3 patients). The overall survival was 72.2% (13 of 18). No patient had encephalopathy over a mean follow up of 30 months.CONCLUSION:
Gastroesophageal devascularization with variceal under-running without esophageal transection is an effective and safe alternative to shunt surgery in the emergency situation.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Feminino
/
Humanos
/
Masculino
/
Varizes Esofágicas e Gástricas
/
Estudos Retrospectivos
/
Tratamento de Emergência
/
Hemorragia Gastrointestinal
/
Pessoa de Meia-Idade
Tipo de estudo:
Estudo observacional
Idioma:
Inglês
Ano de publicação:
1999
Tipo de documento:
Artigo
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