Beppu T, Maruyama T, Ohashi K, Ohura S, Nakanishi R, Fukasawa M, Futagawa S
Second Department of Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1992 Sep;93(9):1159-63.
A total of 508 patients had an non-decompression surgery for esophago-gastric varices in our department, from September 1979 to December 1991. These patients consisted of 387 cases of transthoracic esophageal transection with para-esophagogastric devascularization, 40 cases of transabdominal esophageal transection, and 81 cases of Hassab procedure. The original diseases were cirrhosis in 432 patients, IPH in 35, extrahepatic-portal occlusion in 24, primary biliary cirrhosis in 6, Budd-Chiari syndrome in 4, and others in 7. Operative mortality rate was 5.3%. By thoracic approach, esophageal varices completely disappeared. Postoperative cumulative variceal recurrence and bleeding rates at 10 years were 12% and 7%, although recurrence occurred more often than not in cases with hepatocellular carcinoma (HCC). Cumulative survival rates at 5, 10 years were 69%, 46% in liver cirrhosis without HCC. Present study confirmed that our non-decompression surgery is effective in controlling esophagogastric varices in long term of periods.
1979年9月至1991年12月，我科共有508例患者接受了食管胃静脉曲张非减压手术。这些患者包括387例经胸食管横断术加食管胃旁去血管化、40例经腹食管横断术和81例哈萨布手术。原发病为肝硬化432例、原发性肝内门静脉高压症35例、肝外门静脉阻塞24例、原发性胆汁性肝硬化6例、布加综合征4例、其他7例。手术死亡率为5.3%。经胸手术，食管静脉曲张完全消失。术后10年累积静脉曲张复发率和出血率分别为12%和7%，尽管肝细胞癌（HCC）患者复发更为常见。无HCC的肝硬化患者5年、10年累积生存率分别为69%、46%。本研究证实，我们的非减压手术在长期控制食管胃静脉曲张方面是有效的。
