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Treatment outcomes after splenectomy with gastric devascularization or balloon-occluded retrograde transvenous obliteration for gastric varices: a propensity score-weighted analysis from a single institution.


ABSTRACT: BACKGROUND:Although balloon-occluded retrograde transvenous obliteration (BRTO) is often selected to treat gastric varices caused by portal hypertension, data comparing BRTO and splenectomy with gastric devascularization (Sp?+?Dev) are limited. METHODS:From January 2009 to February 2018, 100 patients with gastric varices caused by portal hypertension who underwent Sp?+?Dev (n?=?45) or BRTO (n?=?55) were included. Overall survival (OS) and the rebleeding rate were calculated using the inverse probability of a treatment weighting-adjusted log-rank test. Independent risk factors were identified by Cox regression analysis. Changes in liver function and adverse events after the procedures were analyzed. RESULTS:Patients in the Sp?+?Dev group tended to have lower platelet counts than those in the BRTO group, but liver function did not differ between these groups. The 5-year OS rates for the Sp?+?Dev and BRTO groups were 73.4 and 50.0% (p?=?0.005), respectively. There were no significant differences in rebleeding rates between the two groups. Multivariate analysis showed that serum albumin level ?3.6 g/dL, prothrombin time% activity (PT%) ?80%, and serum creatinine level ?0.84 mg/dL were poor prognostic factors. Although the Sp?+?Dev group had more short-term complications after procedures, Sp?+?Dev tended to be more effective in improving liver function than BRTO. CONCLUSIONS:Sp?+?Dev showed better OS and improvement of liver function compared with BRTO for the treatment of gastric varices caused by portal hypertension.

SUBMITTER: Oshita K 

PROVIDER: S-EPMC7289714 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Treatment outcomes after splenectomy with gastric devascularization or balloon-occluded retrograde transvenous obliteration for gastric varices: a propensity score-weighted analysis from a single institution.

Oshita Ko K   Ohira Masahiro M   Honmyo Naruhiko N   Kobayashi Tsuyoshi T   Murakami Eisuke E   Aikata Hiroshi H   Baba Yasutaka Y   Kawano Reo R   Awai Kazuo K   Chayama Kazuaki K   Ohdan Hideki H  

Journal of gastroenterology 20200612 9


<h4>Background</h4>Although balloon-occluded retrograde transvenous obliteration (BRTO) is often selected to treat gastric varices caused by portal hypertension, data comparing BRTO and splenectomy with gastric devascularization (Sp + Dev) are limited.<h4>Methods</h4>From January 2009 to February 2018, 100 patients with gastric varices caused by portal hypertension who underwent Sp + Dev (n = 45) or BRTO (n = 55) were included. Overall survival (OS) and the rebleeding rate were calculated using  ...[more]

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