[Sugiura's operation in the treatment of hemorrhaging esophageal varices].
Rebleeding, the long time high occurrence of encephalopathy and the impairment of hepatic function in the successful cases have led to increasing dissatisfaction in the last years with portasystemic shunt procedures. In the past 12 years we have operated on 14 children for bleeding esophageal varices using the Sugiura procedure (esophageal transection with paraesophagogastric devascularization); in two cases the entire procedure was performed through the thoracic approach. We had no mortality. Complications include bleeding in the early postoperative period in two children and partial leakage from the esophageal suture in two others. Patient follow-up has been between 16 months and 11 1/2 years with an average of 6 1/2 years. The long term controls have been gratifying in 12 patients with disappearance of the varices and no evidence of rebleeding, esophageal strictures, gastroesophageal reflux, encephalopathy or impairment of the hepatic function; in two other patients the operations was unsuccessful. In our opinion the Sugiura procedure should be the elected operation in the surgical treatment of esophageal varices bleeding in pediatric age, after an attempt with sclerotherapy.
D002648:Child; D002675:Child, Preschool; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery*; D004947:Esophagus / Q000098:blood supply / Q000601:surgery*; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008722:Methods; D011183:Postoperative Complications; D013270:Stomach / Q000098:blood supply; D013997:Time Factors; D014656:Vascular Surgical Procedures
Trattamento delle varici esofagee sanguinanti con l'operazione di Sugiura.