Sonographic features of umbilical vein recanalization for a Rex shunt on cavernous transformation of portal vein in children

Zhang, Yuqing; Wang, Qing; Wu, Mei; Li, Ya; Wei, Xiuliang; Zhang, Fei-Xue; Li, Yan; Shao, Guang-rui

doi:10.12998/wjcc.v8.i22.5555

Cited by 2 publications

(3 citation statements)

References 27 publications

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“…The clinical symptoms of CTPV are insidious, and the patient has no special discomfort. As the disease progresses, patients develop splenomegaly, hypersplenism, and gastrointestinal bleeding; approximately 10% of children with CTPV die from recurrent upper gastrointestinal bleeding and shock ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Meso-Rex bypass shunt vs. transposition shunt for cavernous transformation of portal vein in children

Song

et al. 2022

Front. Pediatr.

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BackgroundCavernous transformation of the portal vein (CTPV) causes portal hypertension in children. Among Meso-Rex treatments, it is unclear whether the Meso-Rex bypass shunt (MRB) or the Meso-Rex transposition shunt (MRT) offers lower postoperative morbidity. Our objective was to evaluate postoperative outcomes, comparing MRB and MRT for children with CTPV.MethodsA retrospective study was conducted on children undergoing Meso-Rex for CTPV from January 2010 to December 2020. The primary outcome was shunt complications, including shunt stenosis and thrombus. The secondary outcome was re-operation.ResultsOf the 43 patients included, 21 underwent MRT and 22 underwent MRB. MRT was associated with a higher rate of shunt complications when compared to MRB (23.8 vs. 9.1%, p = 0.191). The patients exhibited a higher rate of re-operation under the MRT than under the MRB (19 vs. 4.5%, p = 0.138). The operative time in the MRT group was significantly shorter than in the MRB group. Compared to MRT, the reduction in the length and thickness of the spleen was significantly greater in the MRB group. The increases in platelets were significantly higher in the MRB group than in the MRT group. The postoperative shunt velocity of MRB was notably faster than MRT. There was no significant difference in postoperative portal pressure between the two groups (p > 0.05).ConclusionBoth MRB and MRT result in acceptable postoperative outcomes, but MRT is associated with higher post-shunt complications, which often increase the re-operation rate. This study suggests that MRB may offer advantages for children with CTPV.

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Section: Introductionmentioning

confidence: 99%

Meso-Rex bypass shunt vs. transposition shunt for cavernous transformation of portal vein in children

Song

et al. 2022

Front. Pediatr.

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“…Есть сообщения и других авторов о применении ПВ после ее реканализации и дилатации для МПШ [33]. Для ПВ характерно статистически более частое развитие тромбоза шунта в первые 7 сут послеоперационного периода (40%) [34]. Такую тенденцию объясняют спазмом ПВ.…”

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“…После проведения антикоагулянтной терапии в сроки до 3 мес частота тромбоза шунта уменьшается до 13,3%, в контрольной группе -9,4%. Предполагают, что применение реканализованной ПВ у детей с ВПГ может быть целесообразно при гипоплазии левой ветви ВВ в углублении Rex, облегчая выполнение технически сложного этапа -формирования проксимального анастомоза [34].…”

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Liver reportalization in extrahepatic portal hypertension

Yagudin

2023

Ann. hir. gepatol.

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The study involved literature review of history and current state of surgical treatment in extrahepatic portal hypertension in children and adults. The author analyzed Russian and foreign publications on surgical repair of hepatopetal blood flow in extrahepatic portal hypertension. The issue is a high priority in Russia, which is confirmed by the fact that the author found out the pioneer studies of Russian authors, which were published earlier than the works of foreign researchers. It was found that the role of hepatopetal blood flow restoration in extrahepatic portal hypertension in adults had been much less studied than in children. More clinical material is to be gathered to determine the feasibility of such interventions in adults.

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Sonographic features of umbilical vein recanalization for a Rex shunt on cavernous transformation of portal vein in children

Cited by 2 publications

References 27 publications

Meso-Rex bypass shunt vs. transposition shunt for cavernous transformation of portal vein in children

Meso-Rex bypass shunt vs. transposition shunt for cavernous transformation of portal vein in children

Liver reportalization in extrahepatic portal hypertension

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