| Comparison of the effectiveness and security of modified Sugiura surgery and selective devascularization in the treatment of portal hypertension combined with esophageal and gastric varices |
| Received:December 16, 2020 Revised:April 02, 2021 Click here to download the full text |
| Citation of this paper:XIA Zhen-guo,YAO Lan-qing,ZUO Cheng-kai,CHEN Zhong.Comparison of the effectiveness and security of modified Sugiura surgery and selective devascularization in the treatment of portal hypertension combined with esophageal and gastric varices[J].Chinese Journal of Clinical Medicine,2021,28(4):531-538 |
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| Author Name | Affiliation | E-mail | | XIA Zhen-guo | Department of General Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China | | | YAO Lan-qing | Department of General Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China | | | ZUO Cheng-kai | Department of General Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China | | | CHEN Zhong | Department of General Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China | chenz9806@163.com |
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| Abstract:Objective: To compare the clinical efficacy of patients with portal hypertension (PHT) combined with esophageal and gastric varices bleeding (EGVB) by modified Sugiura surgery and selective devascularization.Methods: From September 2005 to December 2019, 45 patients underwent modified Sugiura surgery (modified group) and 65 patients underwent selective devascularization (selected group). the clinical data of these patients were collected. The cumulative survival rate, rebleeding rate, and remission rate of esophageal and gastric varices were retrospectively analyzed.Results: In the short term (within 3 months), the postoperative mortality rate in the modified and selected groups was 2.22% and 1.54%, respectively. There was no significant difference in the incidence of recent complications and mortality after surgery between the two groups. The final follow-up date was Dec 1, 2019. In the modified group, the cumulative 1-, 3-, and 5-year survival rates were 97.14%, 84.62%, and 78.26%; the cumulative 1-, 3-, and 5-year rebleeding rates were 2.78%, 12.00%, and 18.18%; at the three to six months after surgery, 1 year after surgery, and until the final follow-up date, esophageal and gastric varices remission rate was 92.68%, 87.80%, and 82.93%, respectively. In the selected group, the cumulative 1-, 3-, and 5-year survival rates were 98.00%, 89.19%, and 71.43%; the cumulative 1-, 3-, and 5-year rebleeding rates were 3.85%, 21.95%, and 43.75%; at the three to six months after surgery, 1 year after surgery, and until the final follow-up date, esophageal and gastric varices remission rate was 92.86%, 87.50%, and 64.29%, respectively. There was no significant difference in the cumulative survival rate and incidence of complication between the two groups. There were significant differences in the cumulative rebleeding rate and esophageal and gastric varices remission rate between the two groups (P<0.05).Conclusions: Both types of devascularization are effective methods for the patients with PHT combined with EGVB, and have similar short and long-term prognosises. Howere, for patients with moderate or severe esophageal and gastric varices combined with a history of bleeding, the modified Sugiura surgery has better long-term effect and should be selected first. |
| keywords:portal hypertension modified Sugiura surgery selective devascularization long-term effect rebleeding |
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