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Titolo:
MESOCAVAL SHUNT OR REPEATED SCLEROTHERAPY - EFFECTS ON REBLEEDING ANDENCEPHALOPATHY - A RANDOMIZED TRIAL
Autore:
ISAKSSON B; JEPPSSON B; BENGTSSON F; HANNESSON P; HERLIN P; BENGMARK S;
Indirizzi:
UNIV LUND HOSP,DEPT SURG S-22185 LUND SWEDEN UNIV LUND HOSP,DEPT SURG S-22185 LUND SWEDEN UNIV LUND HOSP,DEPT CLIN PHARMACOL S-22185 LUND SWEDEN UNIV LUND HOSP,DEPT ROENTGENOL S-22185 LUND SWEDEN
Titolo Testata:
Surgery
fascicolo: 5, volume: 117, anno: 1995,
pagine: 498 - 504
SICI:
0039-6060(1995)117:5<498:MSORS->2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
DISTAL SPLENORENAL SHUNT; BLEEDING ESOPHAGEAL-VARICES; ENDOSCOPIC SCLEROTHERAPY; PORTACAVAL-SHUNT; ELECTIVE TREATMENT; CLINICAL-TRIAL; HEMORRHAGE; CIRRHOSIS; CONTROVERSIES; MANAGEMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
21
Recensione:
Indirizzi per estratti:
Citazione:
B. Isaksson et al., "MESOCAVAL SHUNT OR REPEATED SCLEROTHERAPY - EFFECTS ON REBLEEDING ANDENCEPHALOPATHY - A RANDOMIZED TRIAL", Surgery, 117(5), 1995, pp. 498-504

Abstract

Background. Sclerotherapy is usually effective in controlling acutelybleeding esophageal varices. It may nob be as effective as shunt surgery for prevention of rebleeding; therefore we undertook a prospectivestudy comparing interposition mesocaval shunt (MCS) and repeated sclerotherapy. Methods. Forty-five patients (mean age, 52.6 +/- 9.8 years)with variceal bleeding were randomized after emergency endoscopic sclerotherapy either to repeat variceal obliteration followed by regular check endoscopy (n = 21) or to elective interposition mesocaval shunting by use of 14 mm polytetrafluoroethylene graft (n = 24). There was an equal distribution of Child's classes in the two groups. Results. Inthe sclerotherapy group 12 patients had recurrent hemorrhages causingfive deaths compared with the shunt group, in which four patients hadpostoperative bleeding but without associated death, No difference was noted in the incidence of encephalopathy despite the development of total shunting I year after MCS. The median hospital stay teas similar; 34.5 days (MCS) and 33 days (sclerotherapy). The number of intensivecare unit days was also similar in the two groups. No difference was noted in survival in patients with Child's A and Child's B disease in the treatment groups. In patients with Child's C cirrhosis there was astatistically significant longer survival in patients underoing MCS compared with patients undergoing sclerotherapy. Conclusions. The results of the study show that the rate of rebleeding is significantly higher after sclerotherapy than after mesocaval shunting. In patients withChild's C cirrhosis n ICS mall be an alternative to sclerotherapy forthe prevention of rebleeding from esophageal varices in patients not suitable Jar transplantation.

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Documento generato il 29/09/20 alle ore 17:25:35