A prospective randomized trial of selective versus nonselective esophagogastric devascularization for portal hypertension.
10.1007/s11596-014-1316-y
- Author:
Chao WANG
1
;
Liang XIAO
;
Juan HAN
;
Chang-e JIN
;
Yin PENG
;
Zhen YANG
Author Information
1. Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China, wangchao75@163.com.
- Publication Type:Journal Article
- MeSH:
Adult;
Esophagus;
blood supply;
surgery;
Female;
Gastrointestinal Hemorrhage;
etiology;
pathology;
physiopathology;
Hepatic Encephalopathy;
pathology;
physiopathology;
Humans;
Hypertension, Portal;
pathology;
physiopathology;
surgery;
In Vitro Techniques;
Male;
Middle Aged;
Postoperative Complications;
pathology;
physiopathology;
Prospective Studies;
Stomach;
blood supply;
surgery;
Thrombosis;
etiology;
pathology;
physiopathology
- From:
Journal of Huazhong University of Science and Technology (Medical Sciences)
2014;34(4):563-568
- CountryChina
- Language:English
-
Abstract:
Cirrhosis with portal hypertension is a common disease which has a significant impact on the quality of patients' life. Esophagogastric devascularization (EGDV) has been demonstrated to be an effective method to treat portal hypertension, however certain complications are associated with it. The purpose of this study was to evaluate the effectiveness and clinical outcome of the selective EGDV (sEGDV) for the treatment of portal hypertension. The study was conducted prospectively from Jan. 1 2011 to Dec. 31, 2012, and 180 patients were randomized to the sEGDV group (n=90) or the non-sEGDV (n-sEGDV) group (n=90). Patients' demographics, preoperative lab test results and operative details were comparable between the two groups. Postoperative and short-term complications were analyzed in two groups. There was statistically significant difference (P<0.01) in the PVF reduction between the two groups. Post-operative complications showed no statistically significant difference between the two groups in the incidence of bleeding, ascites, acute portal vein thrombosis, fever and hepatic encephalopathy. Mortality between two groups was comparable. The incidence of splenic fossa effusion after the surgery was lower in sEGDV group than in n-sEGDV group. There were no significant differences in the short-term follow-up data such as esophageal varices and portal hypertensive gastropathy (P>0.05). It is suggested that sEGDV is a safe, simple and effective surgical procedure. It has both the advantages of the shunt and devascularization because it preserves body's voluntary diversion. With the advantage of low incidence of postoperative complications, it is an ideal surgical approach for the treatment of portal hypertension.
