A modified Sugiura operation for bleeding varices in children

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Hepatology

Background:

• Esophageal varices hemorrhage poses a life-threatening risk in children.
• Traditional portal systemic shunting has limitations, including encephalopathy and inadequacy in young children.

Purpose of the Study:

• To present a modified Sugiura operation for pediatric patients with bleeding esophageal varices.
• To evaluate the safety and efficacy of this surgical technique.

Main Methods:

• Eight children underwent a modified Sugiura operation for bleeding varices caused by portal vein thrombosis, congenital hepatic fibrosis, chronic active hepatitis, or cystic fibrosis.
• The modified technique involves a single thoracoabdominal incision, stapler-assisted esophageal anastomosis, preserved vagal innervation, and gastric fundus wrapping.

Main Results:

• The modified operation was shorter and simpler than the original Sugiura procedure.
• No evidence of rebleeding from esophageal varices was observed in the long term.
• Complications included one anastomotic leak and one esophageal stricture.

Conclusions:

• The modified Sugiura operation is a preferred surgical therapy for pediatric bleeding esophageal varices.
• This technique preserves upper gastrointestinal tract structure and function, as well as portal venous drainage to the liver.