title: Transection of the esophagus is optional in the Modified Sugiura procedure.
abstract: 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.
authors.affiliation: General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Guo-Shiou
authors.initials: GS
authors.lastname: Liao
authors.forename: Meng-Hang
authors.initials: MH
authors.lastname: Wu
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
authors.forename: Hurng-Sheng
authors.initials: HS
authors.lastname: Wu
authors.forename: Teng-Wei
authors.initials: TW
authors.lastname: Chen
authors.forename: Chung-Bao
authors.initials: CB
authors.lastname: Hsieh
authors.forename: Cheng-Jueng
authors.initials: CJ
authors.lastname: Chen
authors.forename: De-Chuan
authors.initials: DC
authors.lastname: Chan
authors.forename: Tsang-Pai
authors.initials: TP
authors.lastname: Liu
authors.forename: Yao-Chi
authors.initials: YC
authors.lastname: Liu
authors.forename: Tzu-Ming
authors.initials: TM
authors.lastname: Chang
authors.forename: Victor T K
authors.initials: VT
authors.lastname: Chen
mesh_terms: 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