Abstract
Background: The combination of sclerotherapy with surgical salvage for sclerotherapy-resistant esophagogastric varices has recently received much attention, however, the longterm results after such an operation have yet to be reported. This is a preliminary report of a laparoscopic adaptation of a previously described surgical procedure for the treatment of refractory esophagogastric varices. Study Design: Laparoscopic gastric devascularization and splenectomy (Hassab's operation) was successfully performed to treat recurrent sclerotherapy-resistant giant esophageal varices (n = 4) and recurrent rebleeding gastric varices (n = 6). The patients included 8 men and 2 women who ranged in age from 35 to 67 years (average, 54.2 years). The procedure and clinical results were evaluated from various viewpoints. Results: The duration of the operation ranged from 200 to 400 minutes (mean ± standard deviation; 287.5 ± 66.0 minutes) and blood loss from 10 to 1,500 mL (average, 515.5 ± 507.9 mL). The weight of the spleen ranged from 500 to 850 g (average 608.0 ± 126.6 g). Conversion to minimal open operation with a gasless lifting method was done in 1 patient because of uncontrolled bleeding from the splenic vein. There were no other major complications either intraoperatively or postoperatively. All patients had hypersplenism; preoperatire platelet counts ranged from 1.6 to 6.8 x 104/μL (average, 4.5 ± 2.7 x 104 μL) and the postoperative count was from 5.9 to 36.0 x 104/μL (average, 21.7 ± 11.5 x 104 μL). Postoperative endoscopy revealed that varices disappeared, and no patient had recurrence of the varices after operation during the mean followup period of 12.8 ± 4.1 months (average, 8 to 20 months). Conclusions: The combination of laparoscopic gastric devascularization and splenectomy for sclerotherapyresistant esophagogastric varices is considered a feasible and relatively safe surgical method for patients with hypersplenism.
| Original language | English |
|---|---|
| Pages (from-to) | 263-270 |
| Number of pages | 8 |
| Journal | Journal of the American College of Surgeons |
| Volume | 187 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Oct 3 1998 |
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All Science Journal Classification (ASJC) codes
- Surgery
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Laparoscopic gastric devascularization and splenectomy for sclerotherapyo-resistant esophagogastric varices with hypersplenism. / Hashizume, Makoto; Tanoue, Kazuo; Morita, Makoto; Ohta, Masayuki; Tomikawa, Morimasa; Sugimachi, Keizo.
In: Journal of the American College of Surgeons, Vol. 187, No. 3, 03.10.1998, p. 263-270.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic gastric devascularization and splenectomy for sclerotherapyo-resistant esophagogastric varices with hypersplenism
AU - Hashizume, Makoto
AU - Tanoue, Kazuo
AU - Morita, Makoto
AU - Ohta, Masayuki
AU - Tomikawa, Morimasa
AU - Sugimachi, Keizo
PY - 1998/10/3
Y1 - 1998/10/3
N2 - Background: The combination of sclerotherapy with surgical salvage for sclerotherapy-resistant esophagogastric varices has recently received much attention, however, the longterm results after such an operation have yet to be reported. This is a preliminary report of a laparoscopic adaptation of a previously described surgical procedure for the treatment of refractory esophagogastric varices. Study Design: Laparoscopic gastric devascularization and splenectomy (Hassab's operation) was successfully performed to treat recurrent sclerotherapy-resistant giant esophageal varices (n = 4) and recurrent rebleeding gastric varices (n = 6). The patients included 8 men and 2 women who ranged in age from 35 to 67 years (average, 54.2 years). The procedure and clinical results were evaluated from various viewpoints. Results: The duration of the operation ranged from 200 to 400 minutes (mean ± standard deviation; 287.5 ± 66.0 minutes) and blood loss from 10 to 1,500 mL (average, 515.5 ± 507.9 mL). The weight of the spleen ranged from 500 to 850 g (average 608.0 ± 126.6 g). Conversion to minimal open operation with a gasless lifting method was done in 1 patient because of uncontrolled bleeding from the splenic vein. There were no other major complications either intraoperatively or postoperatively. All patients had hypersplenism; preoperatire platelet counts ranged from 1.6 to 6.8 x 104/μL (average, 4.5 ± 2.7 x 104 μL) and the postoperative count was from 5.9 to 36.0 x 104/μL (average, 21.7 ± 11.5 x 104 μL). Postoperative endoscopy revealed that varices disappeared, and no patient had recurrence of the varices after operation during the mean followup period of 12.8 ± 4.1 months (average, 8 to 20 months). Conclusions: The combination of laparoscopic gastric devascularization and splenectomy for sclerotherapyresistant esophagogastric varices is considered a feasible and relatively safe surgical method for patients with hypersplenism.
AB - Background: The combination of sclerotherapy with surgical salvage for sclerotherapy-resistant esophagogastric varices has recently received much attention, however, the longterm results after such an operation have yet to be reported. This is a preliminary report of a laparoscopic adaptation of a previously described surgical procedure for the treatment of refractory esophagogastric varices. Study Design: Laparoscopic gastric devascularization and splenectomy (Hassab's operation) was successfully performed to treat recurrent sclerotherapy-resistant giant esophageal varices (n = 4) and recurrent rebleeding gastric varices (n = 6). The patients included 8 men and 2 women who ranged in age from 35 to 67 years (average, 54.2 years). The procedure and clinical results were evaluated from various viewpoints. Results: The duration of the operation ranged from 200 to 400 minutes (mean ± standard deviation; 287.5 ± 66.0 minutes) and blood loss from 10 to 1,500 mL (average, 515.5 ± 507.9 mL). The weight of the spleen ranged from 500 to 850 g (average 608.0 ± 126.6 g). Conversion to minimal open operation with a gasless lifting method was done in 1 patient because of uncontrolled bleeding from the splenic vein. There were no other major complications either intraoperatively or postoperatively. All patients had hypersplenism; preoperatire platelet counts ranged from 1.6 to 6.8 x 104/μL (average, 4.5 ± 2.7 x 104 μL) and the postoperative count was from 5.9 to 36.0 x 104/μL (average, 21.7 ± 11.5 x 104 μL). Postoperative endoscopy revealed that varices disappeared, and no patient had recurrence of the varices after operation during the mean followup period of 12.8 ± 4.1 months (average, 8 to 20 months). Conclusions: The combination of laparoscopic gastric devascularization and splenectomy for sclerotherapyresistant esophagogastric varices is considered a feasible and relatively safe surgical method for patients with hypersplenism.
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UR - http://www.scopus.com/inward/citedby.url?scp=0031662297&partnerID=8YFLogxK
U2 - 10.1016/S1072-7515(98)00181-1
DO - 10.1016/S1072-7515(98)00181-1
M3 - Article
C2 - 9740183
AN - SCOPUS:0031662297
VL - 187
SP - 263
EP - 270
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
SN - 1072-7515
IS - 3
ER -