Comparison of open, laparoscopic, and hand-assisted laparoscopic devascularization of the upper stomach and splenectomy for treatment of esophageal and gastric varices: a single-center experience

Tomohiko Akahoshi, Hideo Uehara, Morimasa Tomikawa, Hirofumi Kawanaka, Makoto Hashizume, Yoshihiko Maehara

研究成果: Contribution to journalArticle査読

7 被引用数 (Scopus)

抄録

INTRODUCTION: Laparoscopic devascularization of the upper stomach and splenectomy (Dev+Sp), is technically difficult in patients with portal hypertension because of enlarged collateral vessels and spleen. This report presents the efficacy and safety of hand-assisted laparoscopic (HALS) Dev+Sp.

METHODS: Ten patients underwent HALS Dev+Sp as a treatment for esophagogastric varices between 2005 and 2012 (HALS group). A vessel-sealing system was used for devascularization of vessels. An autosuture device was applied to dissect the splenic hilum and the left gastric and enlarged short gastric vessels. The operative and postoperative data were compared between patients who previously underwent laparoscopic Dev+Sp (LAP group, n = 9) and conventional Dev+Sp (OP group, n = 10) between 2001 and 2008.

RESULTS: The mean operative time was 328, 336, and 245 min (P < 0.05) and the mean blood loss was 1786, 981, and 250 mL (P < 0.05) in the OP, LAP, and HALS groups, respectively. Laparoscopic surgery was converted to HALS in one patient and to open surgery in three patients. There were no conversions in the HALS group. There was no significant difference in the cumulative recurrence rate and bleeding rate in the groups.

CONCLUSION: HALS Dev+Sp is a feasible and effective surgery in patients with portal hypertension.

本文言語英語
ページ(範囲)138-144
ページ数7
ジャーナルAsian journal of endoscopic surgery
7
2
DOI
出版ステータス出版済み - 5 1 2014

All Science Journal Classification (ASJC) codes

  • 医学(全般)

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