Transection of the esophagus is optional in the Modified Sugiura procedure.
OBJECTIVE
Esophageal transection in the Modified Sugiura procedure is advocated by some authors, but considered unnecessary by others. We compared the effectiveness of the Modified Sugiura procedure to our simplified Sugiura procedure that omits esophageal transection for the emergency treatment of bleeding esophagogastric varices.


METHODS
From January 1999 to September 2004 we treated 51 patients with cirrhosis of the liver and bleeding esophagogastric varices. All patients had failed management with emergency endoscopy treatment or balloon tamponade with vasopressin infusion. The patients were randomly divided into two groups and underwent the Modified Sugiura procedure with or without esophageal transections.


RESULTS
There were no significant differences in age, gender, cause of cirrhosis, or Child-Pugh classification between the two groups. The preoperative hemoglobin levels, preoperative and intraoperative transfusion volume, mortality, morbidity, and days of hospitalization showed no significant differences between the groups. The operative time was shorter with the simplified Sugiura procedure. The 1-3 year survival rates and the rebleeding rates did not differ significantly between the two groups.


CONCLUSIONS
Both treatments are effective emergency procedures for bleeding esophagogastric varices. Our simplified Sugiura procedure is an effective treatment for bleeding esophagogastric varices and requires a shorter operating time than the Modified Sugiura procedure.
Liao
Guo-Shiou
GS
General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Wu
Meng-Hang
MH
Yu
Jyh-Cherng
JC
Wu
Hurng-Sheng
HS
Chen
Teng-Wei
TW
Hsieh
Chung-Bao
CB
Chen
Cheng-Jueng
CJ
Chan
De-Chuan
DC
Liu
Tsang-Pai
TP
Liu
Yao-Chi
YC
Chang
Tzu-Ming
TM
Chen
Victor T K
VT
D000714:Anastomosis, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery*; D004947:Esophagus / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013156:Splenectomy; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome