Clinical and angiographic assessments and treatment of patients with recurrent varices after transabdominal transection of the esophagus.
OBJECTIVE
Risk factors regarding the recurrence of esophageal varices and were researched preoperative clinical and angiographic findings in patients with variceal recurrence and/or rebleeding after transabdominal esophageal transection were analyzed.


METHODS
Clinical and angiographic assessments of recurrence of varices after transabdominal esophageal transection were made on 55 patients with portal hypertension. In all these patients, postoperative endoscopy was performed at 3-6 monthly intervals.


RESULTS
Varices recurred in 13 patients and 4 patients re-bled during the 5-106 month follow up. There was a significant increase in the rate of recurrence in patients with a history of hematemesis, and in those with a higher grade of development of cephalad collateral vessels in the lesser splanchnic area, as seen on the preoperative portography. Eight of the 13 patients were then effectively treated by endoscopic injection sclerotherapy.


CONCLUSIONS
Despite transabdominal transection of the esophagus, varices may well recur if the patient has had a history of hematemesis and a higher grade of development of cephalad collateral vessels. In such cases endoscopic injection sclerotherapy should be done.
Ariyoshi
T
T
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hashizume
M
M
Kitano
S
S
Koyanagi
N
N
Sugimachi
K
K
D000328:Adult; D000368:Aged; D000792:Angiography; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D006396:Hematemesis; D006801:Humans; D006975:Hypertension, Portal; D008297:Male; D008875:Middle Aged; D011172:Portography; D012008:Recurrence; D015911:Sclerotherapy