Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension
The objective of the work was to study the efficacy of minimally invasive endoscopic treatment of esophageal varices (EV) in children with extrahepatic portal hypertension (EHPH).Methods and Materials. Eighty children aged 3 to 17 years of age with EHPH included in this study. The patients were divi...
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Pavlov First Saint Petersburg State Medical University
2023-10-01
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| Series: | Вестник хирургии имени И.И. Грекова |
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| Online Access: | https://www.vestnik-grekova.ru/jour/article/view/2171 |
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| author | R. Z. Yuldashev M. M. Aliev Sh. I. Shokhaidarov |
| author_facet | R. Z. Yuldashev M. M. Aliev Sh. I. Shokhaidarov |
| author_sort | R. Z. Yuldashev |
| collection | DOAJ |
| description | The objective of the work was to study the efficacy of minimally invasive endoscopic treatment of esophageal varices (EV) in children with extrahepatic portal hypertension (EHPH).Methods and Materials. Eighty children aged 3 to 17 years of age with EHPH included in this study. The patients were divided into three analysis groups. The group I (n=14) included children with EHPH who had not previously undergone any surgical interventions and endoscopic ligation of EV was performed against the background of acute bleeding or after medical hemostatic treatment. The group II (n=37) included patients who had undergone the endoscopic treatment of EV after an unsatisfactory outcome of previously performed surgical interventions. The group III included 29 children who underwent only azygos-portal disconnection procedures. We performed the comparative analysis of the severity of EV before and after sessions of the endoscopic treatment of EV, as well as the analysis of the frequency of recurrent bleedings in comparison groups.Results. According to the research results, recurrent gastroesophageal hemorrhages were noted in 44.4 % of cases in the group I. In the group II, 37 patients underwent a total of 68 sessions of the stage endoscopic treatment of EV. According to the control endoscopic examinations, there was a significant reduction in the risk of bleeding from EV between ligation sessions (p=0.001) of the endoscopic treatment of EV. During the follow-up period, in the group II, recurrent bleedings from EV were noted in 6 (16.2 %) patients. Whereas in 10 (34.5 %) children of the group III, recurrent gastroesophageal hemorrhages were noted in the postoperative period. The analysis showed a significant correlation of the presence of «red flags» with recurrent episodes of bleedings in children of the group II after the endoscopic treatment of EV (r=0.32 p=0.05). Analysis of the causes of recurrent gastroesophageal bleedings in children of the group III did not reveal significant differences in such parameters as the degree of EV and «red flags».Conclusion. Thus, the endoscopic treatment of EV is a safe and effective method of secondary prevention of bleedings from EV. The question concerning the primary prevention of gastroesophageal hemorrhages require further study. |
| format | Article |
| id | doaj-art-ca8397e111f840cd92ba9732fcdc1ccc |
| institution | DOAJ |
| issn | 0042-4625 |
| language | Russian |
| publishDate | 2023-10-01 |
| publisher | Pavlov First Saint Petersburg State Medical University |
| record_format | Article |
| series | Вестник хирургии имени И.И. Грекова |
| spelling | doaj-art-ca8397e111f840cd92ba9732fcdc1ccc2025-08-20T03:02:29ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252023-10-011821354210.24884/0042-4625-2023-182-1-35-421482Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertensionR. Z. Yuldashev0M. M. Aliev1Sh. I. Shokhaidarov2Tashkent Pediatric Medical Institute; Republican Specialized Scientific-Practical Medical Center of PediatricsTashkent Pediatric Medical InstituteRepublican Specialized Scientific-Practical Medical Center of PediatricsThe objective of the work was to study the efficacy of minimally invasive endoscopic treatment of esophageal varices (EV) in children with extrahepatic portal hypertension (EHPH).Methods and Materials. Eighty children aged 3 to 17 years of age with EHPH included in this study. The patients were divided into three analysis groups. The group I (n=14) included children with EHPH who had not previously undergone any surgical interventions and endoscopic ligation of EV was performed against the background of acute bleeding or after medical hemostatic treatment. The group II (n=37) included patients who had undergone the endoscopic treatment of EV after an unsatisfactory outcome of previously performed surgical interventions. The group III included 29 children who underwent only azygos-portal disconnection procedures. We performed the comparative analysis of the severity of EV before and after sessions of the endoscopic treatment of EV, as well as the analysis of the frequency of recurrent bleedings in comparison groups.Results. According to the research results, recurrent gastroesophageal hemorrhages were noted in 44.4 % of cases in the group I. In the group II, 37 patients underwent a total of 68 sessions of the stage endoscopic treatment of EV. According to the control endoscopic examinations, there was a significant reduction in the risk of bleeding from EV between ligation sessions (p=0.001) of the endoscopic treatment of EV. During the follow-up period, in the group II, recurrent bleedings from EV were noted in 6 (16.2 %) patients. Whereas in 10 (34.5 %) children of the group III, recurrent gastroesophageal hemorrhages were noted in the postoperative period. The analysis showed a significant correlation of the presence of «red flags» with recurrent episodes of bleedings in children of the group II after the endoscopic treatment of EV (r=0.32 p=0.05). Analysis of the causes of recurrent gastroesophageal bleedings in children of the group III did not reveal significant differences in such parameters as the degree of EV and «red flags».Conclusion. Thus, the endoscopic treatment of EV is a safe and effective method of secondary prevention of bleedings from EV. The question concerning the primary prevention of gastroesophageal hemorrhages require further study.https://www.vestnik-grekova.ru/jour/article/view/2171esophageal varicesbleedingextrahepatic portal hypertensionendoscopic ligationazygos-portal disconnectioectopic varix |
| spellingShingle | R. Z. Yuldashev M. M. Aliev Sh. I. Shokhaidarov Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension Вестник хирургии имени И.И. Грекова esophageal varices bleeding extrahepatic portal hypertension endoscopic ligation azygos-portal disconnectio ectopic varix |
| title | Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension |
| title_full | Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension |
| title_fullStr | Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension |
| title_full_unstemmed | Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension |
| title_short | Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension |
| title_sort | minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension |
| topic | esophageal varices bleeding extrahepatic portal hypertension endoscopic ligation azygos-portal disconnectio ectopic varix |
| url | https://www.vestnik-grekova.ru/jour/article/view/2171 |
| work_keys_str_mv | AT rzyuldashev minimalinvasiveprophylaxisofbleedingfromesophagealvaricesinchildrenwithextrahepaticportalhypertension AT mmaliev minimalinvasiveprophylaxisofbleedingfromesophagealvaricesinchildrenwithextrahepaticportalhypertension AT shishokhaidarov minimalinvasiveprophylaxisofbleedingfromesophagealvaricesinchildrenwithextrahepaticportalhypertension |