Since first learning about the Sugiura Procedure for oesophageal bleeding, I have wanted to write something about it but had difficulty actually deciphering the material from medical terminology into language that was understandable for most. Besides scouring the internet I also tried to find understandable information in book form at my local library, and surprisingly I came up short. Before trying to explain (albeit briefly below) online medical dictionaries define the procedure in the following manner, “Oesophageal transection with paraoesophageal devascularisation, for oesophageal varices”.
As best as I can describe the Sugiura procedure, surgeons would ligate (tie-off) the penetrating oesophageal veins that originate from the portal system in order to stop the bleeding. To maintain critical venous drainage of the oesophagus and stomach the left gastric and paraesophageal veins are left intact. A splenectomy (removal of the spleen) is performed because it is usually congested and non-functioning. Some articles I have read indicate that there have been some modifications to the procedure and with that there has been some reported success. Although the Japanese (University of Tokyo) have reported favourable long-term results, the technique has not been widely accepted in the Western Hemisphere (except for Mexico) because of high postoperative mortality rates. On a recent visit to my gastroenterologist I inquired about the procedure, and she confirmed what I read and stated that it is only performed as a last resort where all other procedures have failed.
Through personal research, personal interaction I have had with other sufferers, plus the advice of a few of my own specialists I remain committed to the task of posting accurate information on new techniques and medical findings for this most disconcerting condition of portal hypertension. The Sugiura procedure is much more complicated than what I have tried to explain here, so maybe you have more information to share than what I have provided? At any rate your comments or questions are always welcome!
Until next time,