Safety and Efficacy of a Novel Shunt Surgery Combined with Foam Sclerotherapy of Varices for Prehepatic Portal Hypertension: A Pilot Study
This pilot study investigated the safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices in patients with prehepatic portal hypertension. Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into thr...
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| Veröffentlicht in: | Clinics (São Paulo, Brazil) Brazil), 2019, Vol.74, p.e704, Article e704 |
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| creator | Zhang, Zhe Chen, Xueming Li, Chenyu Feng, Hai Yu, Hongzhi Zhu, Renming Wang, Tianyou |
| description | This pilot study investigated the safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices in patients with prehepatic portal hypertension.
Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into three groups by surgery type: shunt surgery alone (Group A), shunt surgery and devascularization (Group B), and shunt surgery combined with foam sclerotherapy (Group C). Between-group differences in operation time, intraoperative blood loss, portal pressure decrease, postoperative complications, rebleeding rates, encephalopathy, mortality rates and remission of gastroesophageal varices were compared.
Groups A, B and C had similar operation times, intraoperative bleeding, and portal pressure decrease. The remission rates of varices differed significantly (p |
| doi_str_mv | 10.6061/clinics/2019/e704 |
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Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into three groups by surgery type: shunt surgery alone (Group A), shunt surgery and devascularization (Group B), and shunt surgery combined with foam sclerotherapy (Group C). Between-group differences in operation time, intraoperative blood loss, portal pressure decrease, postoperative complications, rebleeding rates, encephalopathy, mortality rates and remission of gastroesophageal varices were compared.
Groups A, B and C had similar operation times, intraoperative bleeding, and portal pressure decrease. The remission rates of varices differed significantly (p<0.001): one patient in Group A and 6 patients in Group B had partial response, and all 9 patients in Group C had remission (2 complete, 7 partial). Two Group A patients and one Group B patient developed recurrent gastrointestinal bleeding postoperatively within 12 months. No postoperative recurrence or bleeding was observed in Group C, and no sclerotherapy-related complications were observed.
Shunt surgery combined with foam sclerotherapy obliterates varices more effectively than shunt surgery alone does, decreasing the risk of postoperative rebleeding from residual gastroesophageal varices. This novel surgery is safe and effective with good short-term outcomes.</description><identifier>ISSN: 1807-5932</identifier><identifier>ISSN: 1980-5322</identifier><identifier>EISSN: 1980-5322</identifier><identifier>DOI: 10.6061/clinics/2019/e704</identifier><identifier>PMID: 31433045</identifier><language>eng</language><publisher>Brazil: Elsevier España, S.L.U</publisher><subject>Adolescent ; Adult ; Child ; Esophageal and Gastric Varices - surgery ; Female ; Foam Sclerotherapy ; Gastroesophageal Varices ; Gastrointestinal Hemorrhage - etiology ; Humans ; Hypertension, Portal - surgery ; Intraoperative Complications ; Male ; MEDICINE, GENERAL & INTERNAL ; Middle Aged ; Original ; Pilot Projects ; Postoperative Complications ; Postoperative Hemorrhage - etiology ; Prehepatic Portal Hypertension ; Retrospective Studies ; Sclerotherapy - adverse effects ; Sclerotherapy - methods ; Shunt Surgery ; Young Adult</subject><ispartof>Clinics (São Paulo, Brazil), 2019, Vol.74, p.e704, Article e704</ispartof><rights>2019 CLINICS</rights><rights>Copyright © 2019 CLINICS 2019</rights><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c556t-e01a852019307a2151a9e48808df5265d437e3c342649c1b652780324700344e3</citedby><cites>FETCH-LOGICAL-c556t-e01a852019307a2151a9e48808df5265d437e3c342649c1b652780324700344e3</cites><orcidid>0000-0003-0439-4564 ; 0000-0001-6945-2919 ; 0000-0002-4588-0967 ; 0000-0001-6965-3622 ; 0000-0002-1559-6113 ; 0000-0001-8771-568X ; 0000-0002-6422-9299</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691837/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691837/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,4009,27902,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31433045$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Zhe</creatorcontrib><creatorcontrib>Chen, Xueming</creatorcontrib><creatorcontrib>Li, Chenyu</creatorcontrib><creatorcontrib>Feng, Hai</creatorcontrib><creatorcontrib>Yu, Hongzhi</creatorcontrib><creatorcontrib>Zhu, Renming</creatorcontrib><creatorcontrib>Wang, Tianyou</creatorcontrib><title>Safety and Efficacy of a Novel Shunt Surgery Combined with Foam Sclerotherapy of Varices for Prehepatic Portal Hypertension: A Pilot Study</title><title>Clinics (São Paulo, Brazil)</title><addtitle>Clinics (Sao Paulo)</addtitle><description>This pilot study investigated the safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices in patients with prehepatic portal hypertension.
Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into three groups by surgery type: shunt surgery alone (Group A), shunt surgery and devascularization (Group B), and shunt surgery combined with foam sclerotherapy (Group C). Between-group differences in operation time, intraoperative blood loss, portal pressure decrease, postoperative complications, rebleeding rates, encephalopathy, mortality rates and remission of gastroesophageal varices were compared.
Groups A, B and C had similar operation times, intraoperative bleeding, and portal pressure decrease. The remission rates of varices differed significantly (p<0.001): one patient in Group A and 6 patients in Group B had partial response, and all 9 patients in Group C had remission (2 complete, 7 partial). Two Group A patients and one Group B patient developed recurrent gastrointestinal bleeding postoperatively within 12 months. No postoperative recurrence or bleeding was observed in Group C, and no sclerotherapy-related complications were observed.
Shunt surgery combined with foam sclerotherapy obliterates varices more effectively than shunt surgery alone does, decreasing the risk of postoperative rebleeding from residual gastroesophageal varices. This novel surgery is safe and effective with good short-term outcomes.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>Esophageal and Gastric Varices - surgery</subject><subject>Female</subject><subject>Foam Sclerotherapy</subject><subject>Gastroesophageal Varices</subject><subject>Gastrointestinal Hemorrhage - etiology</subject><subject>Humans</subject><subject>Hypertension, Portal - surgery</subject><subject>Intraoperative Complications</subject><subject>Male</subject><subject>MEDICINE, GENERAL & INTERNAL</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Pilot Projects</subject><subject>Postoperative Complications</subject><subject>Postoperative Hemorrhage - etiology</subject><subject>Prehepatic Portal Hypertension</subject><subject>Retrospective Studies</subject><subject>Sclerotherapy - adverse effects</subject><subject>Sclerotherapy - methods</subject><subject>Shunt Surgery</subject><subject>Young Adult</subject><issn>1807-5932</issn><issn>1980-5322</issn><issn>1980-5322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNp9Ustu1DAUjRCIlsIHsEH-gen4nQQkpGrU0koVjBRga3mc64lHmThynEH5Bb4apykV3bCyZd_zuEcny94TfCmxJGvTus6ZYU0xKdeQY_4iOydlgVeCUfoy3Qucr0TJ6Fn2ZhgOGLOScfE6O2OEM4a5OM9-V9pCnJDuanRtrTPaTMhbpNFXf4IWVc3YRVSNYQ9hQht_3LkOavTLxQbdeH1ElWkh-NhA0P0D8qcOzsCArA9oG6CBXkdn0NaHqFt0O_UQInSD891HdIW2rvWJP4719DZ7ZXU7wLvH8yL7cXP9fXO7uv_25W5zdb8yQsi4Akx0IeaVGc41JYLoEnhR4KK2gkpRc5YDM4xTyUtDdlLQvMCM8jztzzmwi-xu4a29Pqg-uKMOk_LaqYcHH_ZKh2S5BcWkZdzWKeua8TzpSiyMpYbbkktWlonrcuEajIPWq4MfQ5fMq2rOXs3Zz04xxgRjKkQCfF4A_bg7Qm2gi0G3z1w8_-lco_b-pKQsScHyREAWAhP8MASwT1iC1dwK9dgKNQuruRUJ8-Ff0SfE3xqkgU_LAKTcTw6CmvfpDNQugIkpGPcf-j-EPMcp</recordid><startdate>2019</startdate><enddate>2019</enddate><creator>Zhang, Zhe</creator><creator>Chen, Xueming</creator><creator>Li, Chenyu</creator><creator>Feng, Hai</creator><creator>Yu, Hongzhi</creator><creator>Zhu, Renming</creator><creator>Wang, Tianyou</creator><general>Elsevier España, S.L.U</general><general>Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo</general><general>Faculdade de Medicina / USP</general><general>Elsevier España</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><scope>GPN</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0439-4564</orcidid><orcidid>https://orcid.org/0000-0001-6945-2919</orcidid><orcidid>https://orcid.org/0000-0002-4588-0967</orcidid><orcidid>https://orcid.org/0000-0001-6965-3622</orcidid><orcidid>https://orcid.org/0000-0002-1559-6113</orcidid><orcidid>https://orcid.org/0000-0001-8771-568X</orcidid><orcidid>https://orcid.org/0000-0002-6422-9299</orcidid></search><sort><creationdate>2019</creationdate><title>Safety and Efficacy of a Novel Shunt Surgery Combined with Foam Sclerotherapy of Varices for Prehepatic Portal Hypertension: A Pilot Study</title><author>Zhang, Zhe ; Chen, Xueming ; Li, Chenyu ; Feng, Hai ; Yu, Hongzhi ; Zhu, Renming ; Wang, Tianyou</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c556t-e01a852019307a2151a9e48808df5265d437e3c342649c1b652780324700344e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>Esophageal and Gastric Varices - surgery</topic><topic>Female</topic><topic>Foam Sclerotherapy</topic><topic>Gastroesophageal Varices</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>Humans</topic><topic>Hypertension, Portal - surgery</topic><topic>Intraoperative Complications</topic><topic>Male</topic><topic>MEDICINE, GENERAL & INTERNAL</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Pilot Projects</topic><topic>Postoperative Complications</topic><topic>Postoperative Hemorrhage - etiology</topic><topic>Prehepatic Portal Hypertension</topic><topic>Retrospective Studies</topic><topic>Sclerotherapy - adverse effects</topic><topic>Sclerotherapy - methods</topic><topic>Shunt Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Zhe</creatorcontrib><creatorcontrib>Chen, Xueming</creatorcontrib><creatorcontrib>Li, Chenyu</creatorcontrib><creatorcontrib>Feng, Hai</creatorcontrib><creatorcontrib>Yu, Hongzhi</creatorcontrib><creatorcontrib>Zhu, Renming</creatorcontrib><creatorcontrib>Wang, Tianyou</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SciELO</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Clinics (São Paulo, Brazil)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Zhe</au><au>Chen, Xueming</au><au>Li, Chenyu</au><au>Feng, Hai</au><au>Yu, Hongzhi</au><au>Zhu, Renming</au><au>Wang, Tianyou</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and Efficacy of a Novel Shunt Surgery Combined with Foam Sclerotherapy of Varices for Prehepatic Portal Hypertension: A Pilot Study</atitle><jtitle>Clinics (São Paulo, Brazil)</jtitle><addtitle>Clinics (Sao Paulo)</addtitle><date>2019</date><risdate>2019</risdate><volume>74</volume><spage>e704</spage><pages>e704-</pages><artnum>e704</artnum><issn>1807-5932</issn><issn>1980-5322</issn><eissn>1980-5322</eissn><abstract>This pilot study investigated the safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices in patients with prehepatic portal hypertension.
Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into three groups by surgery type: shunt surgery alone (Group A), shunt surgery and devascularization (Group B), and shunt surgery combined with foam sclerotherapy (Group C). Between-group differences in operation time, intraoperative blood loss, portal pressure decrease, postoperative complications, rebleeding rates, encephalopathy, mortality rates and remission of gastroesophageal varices were compared.
Groups A, B and C had similar operation times, intraoperative bleeding, and portal pressure decrease. The remission rates of varices differed significantly (p<0.001): one patient in Group A and 6 patients in Group B had partial response, and all 9 patients in Group C had remission (2 complete, 7 partial). Two Group A patients and one Group B patient developed recurrent gastrointestinal bleeding postoperatively within 12 months. No postoperative recurrence or bleeding was observed in Group C, and no sclerotherapy-related complications were observed.
Shunt surgery combined with foam sclerotherapy obliterates varices more effectively than shunt surgery alone does, decreasing the risk of postoperative rebleeding from residual gastroesophageal varices. This novel surgery is safe and effective with good short-term outcomes.</abstract><cop>Brazil</cop><pub>Elsevier España, S.L.U</pub><pmid>31433045</pmid><doi>10.6061/clinics/2019/e704</doi><orcidid>https://orcid.org/0000-0003-0439-4564</orcidid><orcidid>https://orcid.org/0000-0001-6945-2919</orcidid><orcidid>https://orcid.org/0000-0002-4588-0967</orcidid><orcidid>https://orcid.org/0000-0001-6965-3622</orcidid><orcidid>https://orcid.org/0000-0002-1559-6113</orcidid><orcidid>https://orcid.org/0000-0001-8771-568X</orcidid><orcidid>https://orcid.org/0000-0002-6422-9299</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinics (São Paulo, Brazil), 2019, Vol.74, p.e704, Article e704 |
| issn | 1807-5932 1980-5322 1980-5322 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adolescent Adult Child Esophageal and Gastric Varices - surgery Female Foam Sclerotherapy Gastroesophageal Varices Gastrointestinal Hemorrhage - etiology Humans Hypertension, Portal - surgery Intraoperative Complications Male MEDICINE, GENERAL & INTERNAL Middle Aged Original Pilot Projects Postoperative Complications Postoperative Hemorrhage - etiology Prehepatic Portal Hypertension Retrospective Studies Sclerotherapy - adverse effects Sclerotherapy - methods Shunt Surgery Young Adult |
| title | Safety and Efficacy of a Novel Shunt Surgery Combined with Foam Sclerotherapy of Varices for Prehepatic Portal Hypertension: A Pilot Study |
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