title: Usefulness of a recanalized umbilical vein for vascular reconstruction in pediatric hepatic surgery.
abstract: OBJECTIVE
  Pediatric surgeons currently engage in various abdominal vascular surgeries, which sometimes require vascular conduits or grafts. Herein, we report our experience with patients undergoing vascular reconstruction using a recanalized umbilical vein (rUV) and their long-term outcome.
  
  
  METHODS
  Five patients with extrahepatic portal vein obstruction (EHPVO) underwent mesenterico-/porto-left portal vein (PV) bypass surgery using a short rUV conduit with an interposition vein graft. A sixth neonate with a huge hepatic tumor underwent PV reconstruction with anastomosis of rUV to the proximal PV stump following right hepatectomy with partial PV resection. A seventh patient underwent living donor liver transplantation for recurrent hepatoblastoma. The hepatic inferior vena cava (IVC) was resected because of tumor involvement and reconstructed by transposition of the infrahepatic IVC and interposition of rUV obtained from the donor liver graft.
  
  
  RESULTS
  Sufficient flow through rUV was achieved and maintained in all patients without any complications during follow-up (0.7-6.9 years). Esophageal varices, splenomegaly, and other laboratory test abnormalities because of portal hypertension disappeared after surgery in patients with EHPVO.
  
  
  CONCLUSIONS
  Our experience confirmed the usefulness and long-term patency of rUV as an entry to the intrahepatic PV and as a free vascular graft to reconstruct PV or IVC.
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, 138-4 Mutsukawa 2-chome, Minami-ku, Yokohama, 232-8555, Japan. mshinkai@kcmc.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Shinkai
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, 138-4 Mutsukawa 2-chome, Minami-ku, Yokohama, 232-8555, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Mochizuki
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, 138-4 Mutsukawa 2-chome, Minami-ku, Yokohama, 232-8555, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Kitagawa
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, 138-4 Mutsukawa 2-chome, Minami-ku, Yokohama, 232-8555, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Take
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, 138-4 Mutsukawa 2-chome, Minami-ku, Yokohama, 232-8555, Japan.
authors.forename: Hidehito
authors.initials: H
authors.lastname: Usui
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, 138-4 Mutsukawa 2-chome, Minami-ku, Yokohama, 232-8555, Japan.
authors.forename: Kaori Nakamura
authors.initials: KN
authors.lastname: Yamoto
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, 138-4 Mutsukawa 2-chome, Minami-ku, Yokohama, 232-8555, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Fujita
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, 138-4 Mutsukawa 2-chome, Minami-ku, Yokohama, 232-8555, Japan.
authors.forename: Youkatsu
authors.initials: Y
authors.lastname: Ohhama
mesh_terms: D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011169:Portal Vein / Q000601:surgery*; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013997:Time Factors; D014471:Umbilical Veins / Q000637:transplantation*; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Extrahepatic portal vein obstruction; Inferior vena cava reconstruction; Meso-Rex bypass; Umbilical vein; Vascular graft