A new hipothesis about the rex-shunt operation: Using of umblical vein transpozition instead of intestinal jugulary vein graft

Yıl 2006, Cilt: 37 Sayı: 4, 119 - 121, 01.05.2006

Ayşegül Celayir

Öz

In this paper, a new hipothesis about the Rex-shunt operation had been idendiftcation. Rex-shunt operation is new promising treatment modalities for extra-hepatic portal vein trombosis especially in children. In this tecnical innovation; using ofumblical vein transposition instead of internal vein graft is recommended that constructing portal vein by-passing. According to this theory, only one anastomosis could be created instead of two anastomosis of internal jugular vein in original Rex-shunt operation. Thus, complications of anastomosis could be decreased, and internal jugulary vein could be safe as intact.

Anahtar Kelimeler

Hypertension, Portal, Umbilical Veins

Rex shunt ameliyattında yeni bir hipotez: İnternal jugular ven grefti yerine umbilikal ven transpozisyonu

Öz

Bu yazıda Rex shunt ameliyatı hakkında yeni bir hipotez tariflenmektedir. Rex shunt ameliyatı özellikle çocuklar olmak üzere ekstrahepatik portal ven trombozlu olgular için ümit vaad eden bir tedavi seçeneğidir. Bu teknik tariflemede; internal juguler ven grefti yerine umbilikal ven transpozisyonu kullanılarak portal baypas oluşturulması düşünülmüştür. Bu yöntemde, original Rex shunt ameliyatındaki bypass yapılan internal juguler venin iki ucunun anastomozu yerine, sadece bir anastomoz ile ameliyat gerçekleştirilebilir. Böylece anastomoz koplikasyonları azalır ve juguler internal ven sağlam kalmış olur.

Anahtar Kelimeler

Hipertansiyon, portal, Umbilikal venler

Kaynakça

• de Ville de Goyet J, Gibbs P, Clapuyt P, et al: Original extrahilar approach for hepatic portal revascularizasyon and relief of extrahepatic portal hypertension related to later portal vein thrombosis after pediatric liver transplantation: Long term results. Transplantation 62: 71-75, 1996 de Ville de Goyet J, Alberti D, Clapuyt B, et al: Direct bypassing of extrahepatic portal venous obstruction in children: A new technique for combined hepatic portal revascularization and treatment of extrahepatic portal hypertension. J Pediatr Surg 33: 597-601,1998 Bambini DA, Superina R, Almond PS, et al: Experience with the Rex Shunt (mesenterico-left portal bypass) in children with extrahepatic portal hypertension. J Pediatr Surg 35. 13-19, 2000 Moore KL. Fetal and neonatal circulation in the developing human. Clinical oriented embryology. (4th Ed) WB Saunders Company, pp: 321-330, 1998 Otte JB, Reynaert M, de Hemptine B, et al: Arterialization of the portal vein in conjunction with a therapeutic portacaval shunt: Hemodynamic investigations and resuls in 75 patients. Ann Surg 196: 656-663, 1982 Adamsons RJ: Arterialization of the portal vein: Techniques and results. In Rutherford RB (ed.): Vascular surgery, 2nd ed., Philadelphia, WB Saunders, pp: 1061-1070, 1984 Rahman N. Al-Nassr S, Davenport M. Congenital mesenterico-portal (Rex) shunt. Pediatr Surg Int. 18: 514-516, 2002