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The Sugiura procedure is a surgical technique that involves the removal and transection of the blood vessels that supply the upper portion of the stomach and the esophagus. The procedure also involves a splenectomy. The operation was originally developed to treat bleeding esophageal varices (commonly a complication of liver cirrhosis) that were untreatable by other conventional methods. It was originally developed as a two-step operation, but has been modified numerous times by many surgeons since its original creation. == Introduction == The Sugiura procedure was originally developed to treat bleeding esophageal varices and consisted mainly of an esophagogastric devascularization. It was developed in Japan in 1973〔Sugiura M, and Futagawa S. A new technique for treating esophageal varices. The Journal of thoracic and cardiovascular surgery. 1973;66(5):677. 〕 as a nonshunting technique that achieved variceal bleeding hemostasis by interrupting the variceal blood flow along the gastroesophageal junction. The procedure consists primarily of paraesophagogastric devascularization achieved by dividing the perforating veins of the esophagus and the stomach while maintaining the plexus of collaterals that connect the coronary gastric vein to the azygous system. The original procedure also consisted of an esophageal transection, splenectomy, vagotomy, and pyloroplasty. The Sugiura procedure was originally associated with significant morbidity and mortality; in recent years, though, this procedure and its modifications have been performed in many hepatobiliary and pancreatic surgical centers with improving morbidity and mortality rates〔Ginsberg RJ, Waters PF, Zeldin RA, Spratt EH, Shandling B, Stone RM, and Strasberg S. A modified Sugiura procedure. The Annals of thoracic surgery. 1982;34(3):258-264. 〕〔Dagenais M, Langer B, Taylor BR, and Greig PD. Experience with radical esophagogastric devascularization procedures (Sugiura) for variceal bleeding outside Japan. World J Surg. 1994;18(2):222-8. 〕〔Mariette D, Smadja C, Borgonovo G, Grange D, and Franco D. The Sugiura procedure: a prospective experience. Surgery. 1994;115(3):282-289. 〕〔Belloli G, Campobasso P, and Musi L. Sugiura procedure in the surgical treatment of bleeding esophageal varices in children: Long-term results. Journal of pediatric surgery. 1992;27(11):1422-1426. 〕〔Wright AS, and Rikkers LF. Current management of portal hypertension. Journal of gastrointestinal Surgery. 2005;9(7):992-1005. 〕〔Sugiura M, and Futagawa S. Results of six hundred thirty-six esophageal transections with paraesophagogastric devascularization in the treatment of esophageal varices. J Vasc Surg. 1984, Mar;1(2):254-60. 〕〔Sugiura M, and Futagawa S. Further evaluation of the Sugiura procedure in the treatment of esophageal varices. Archives of Surgery. 1977;112(11):1317. 〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Sugiura procedure」の詳細全文を読む スポンサード リンク
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