脐静脉导管检查史并不妨碍儿童成功进行中胚层血管搭桥术。

IF 1.5 3区 医学 Q2 PEDIATRICS European Journal of Pediatric Surgery Pub Date : 2024-02-01 Epub Date: 2023-07-24 DOI:10.1055/s-0043-1771225
Caroline P Lemoine, Stephanie Yang, Katherine A Brandt, Sydney Carra, Riccardo A Superina
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引用次数: 0

摘要

导言:脐静脉导管插入术(UVC)可引起门静脉血栓形成,导致肝外门静脉阻塞(EHPVO)和门静脉高压症(PHT)的发生。对于有紫外线照射史的患者,采用中雷克斯旁路术(MRB)治疗 EHPVO 的可行性一直受到质疑。我们比较了在既往有或没有紫外线照射史的患者中实施 MRB 的可行性:方法:我们对在本院接受 MRB 检查的已知有 UVC 病史的 EHPVO 患者进行了回顾性研究(1997-2022 年)。患者被分为两组:有(UVC(+))或无(UVC(-))UVC病史的患者,以便进行比较。P值小于0.05为有意义:共纳入 187 名患者(紫外线照射(+)组 57 人;紫外线照射(-)组 130 人)。紫外线组患者手术时的年龄明显更小,早产儿的发病率更高。两组患者发生 EHPVO 的其他风险因素相似,但只有 UVC 病史可预测接受 MRB 的能力(几率比 [OR]:7.4 [3.5-15.4];P P = 0.3)在两组中同样高:我们的研究结果表明,有紫外线照射史并不是 MRB 的禁忌症。结论:我们的研究结果表明,UVC 病史并不是 MRB 的禁忌症,半数患者能够成功接受 MRB。EHPVO引起的无症状PHT患者不应因UVC病史而被排除在MRB考虑范围之外。
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A History of Umbilical Vein Catheterization Does Not Preclude Children from a Successful Meso-Rex Bypass.

Introduction:  Umbilical vein catheterization (UVC) can cause portal venous thrombosis, leading to the development of extrahepatic portal venous obstruction (EHPVO) and portal hypertension (PHT). The feasibility of the Meso-Rex bypass (MRB) for the treatment of EHPVO in patients with a history of UVC has been questioned. We compared the feasibility of performing an MRB in patients with or without a history of previous UVC.

Methods:  A retrospective review of patients with EHPVO and known UVC status explored for a possible MRB at our institution was performed (1997-2022). Patients were categorized in two groups: with (UVC(+)) or without (UVC(-)) a history of UVC for comparison. A p-value less than 0.05 was considered significant.

Results:  One hundred and eighty-seven patients were included (n = 57 in UVC(+); n = 130 in UVC(-)). Patients in the UVC group were significantly younger at surgery and the incidence of prematurity was higher. Other risk factors for the development of EHPVO were similar between the groups, but only history of UVC could predict the ability to receive MRB (odds ratio [OR]: 7.4 [3.5-15.4]; p < 0.001). The success rate of MRB was significantly higher in patients with no history of UVC (28/57 [49.1%] in UVC(+) vs. 114/130 [87.7%] in UVC(-); p < 0.001). However, MRB patency at discharge (25/28 [89.3%] in UVC(+) vs. 106/114 [94.7%] in UVC(-); p = 0.3) was equally high in both groups.

Conclusion:  Our results indicate that a history of UVC is not a contraindication to MRB. Half of the patients were able to successfully receive an MRB. Patients with symptomatic PHT from EHPVO should not be excluded from consideration for MRB based on UVC history.

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来源期刊
CiteScore
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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