EXPERIENCE WITH RADICAL ESOPHAGOGASTRIC DEVASCULARIZATION PROCEDURES (SUGIURA) FOR VARICEAL BLEEDING OUTSIDE JAPAN
EXPERIENCE WITH RADICAL ESOPHAGOGASTRIC DEVASCULARIZATION PROCEDURES (SUGIURA) FOR VARICEAL BLEEDING OUTSIDE JAPAN
复制标题
DOI：
10.1007/bf00294405
复制
发表时间：
1994-03-01
影响因子：
2.6
通讯作者：
GREIG, PD
中科院分区：
文献类型：
--
作者：
DAGENAIS, M;LANGER, B;GREIG, PD
据报道，Sugiura手术在肝功能良好、以非酒精为主的日本人群中进行时，手术死亡率、再出血和脑病发生率较低。对日本以外报道的Sugiura手术的文献回顾显示，对于晚期肝病患者，尤其是酒精性肝硬变患者，Sugiura手术作为急诊手术时，并发症和死亡率都很高。非对照研究报告的结果与日本的系列结果差别不大，当手术仅限于择期手术的高风险患者时。我们在Sugiura手术中的经验支持它在这些情况下的作用，特别是在门静脉血栓形成和肝功能正常的患者中。唯一良好的前瞻性对照试验已在血吸虫病患者中进行，提示Sugiura手术远优于全分流术，由于其术后脑病发生率较低，可能略优于Warren分流术。需要进行更多的对照试验，以确定其在酒精性肝硬变的良好至中等风险患者中的作用。
The Sugiura operation has been reported to have low operative mortality, rebleeding, and encephalopathy rates when carried out in a predominantly nonalcoholic Japanese population with good liver function. A literature review of reports of the Sugiura procedure outside Japan reveals a high complication and mortality rate when it is used as an emergency procedure in patients with advanced liver disease, especially in those with alcoholic cirrhosis. Uncontrolled studies report results that differ little from the Japanese series when the operation is confined to good-risk patients in the elective situation. Our experience with the Sugiura operation supports its role in these circumstances, especially in patients with portal vein thrombosis and normal liver function. The only good prospective controlled trial has been carried out in patients with schistosomiasis and suggests that the Sugiura operation is far superior to total shunt and may have a slight advantage over the Warren shunt because of its low incidence of postoperative encephalopathy. More controlled trials are required to establish its role in good- to moderate-risk patients with alcoholic cirrhosis.