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Clinical outcomes of splenorenal shunts in esophageal varices patients: a literature review Putra, I Gusti Agung Made Adnyana; Hakim, Arief Rakhman; Soebroto, Heroe; Sembiring, Yan Efrata; Limanto, Danang Himawan; Rizki, Mohamad; Puruhito
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.40

Abstract

The disease known as esophageal varices is usually caused by portal hypertension. Portal hypertension is most commonly caused by extrahepatic portal vein thrombosis and other conditions, such as cardiac problems or hepatic cirrhosis. Clinical manifestations of esophageal varices can include melena, haematemesis, and gastrointestinal bleeding. Effective venous pressure reduction is achieved via the distal splenorenal shunt. We acquired the literature for our review from PubMed and Google Scholar. The search was done in English using terms that indicated a connection between improvements in bone grafting methods and the restoration of alveolar clefts. To expand the search results, we also looked through the papers cited in the literature. Almost all of the five gathered articles demonstrated that the distal splenorenal shunt (DSRS) is a beneficial surgical treatment that effectively avoids postoperative PH issues. Finally, DSRS is presented as a surgical long-term treatment for variceal esophageal reflux disease and portal hypertension. Because DSRS selectively decompresses the venous collaterals around the stomach and lower esophagus, it is a safe and effective therapy choice for decreasing bleeding over nonselective shunting surgeries as a selective shunt.
Correlation Between Intraoperative Blood Vessel Diameter and Technical Success Rate of AV Shunt Surgery in Dr. Soetomo Hospital Surabaya Saphira, Diva; Soebroto, Heroe; Thaha, Mochammad; Hakim, Arief Rakhman; Widipriyatama, Gabriel Rio
Journal of Indonesia Vascular Access Vol. 3 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i2.45

Abstract

Introduction: An arteriovenous (AV) shunt is an anastomosis between vein and artery made in a surgical procedure as vascular access for patients with end-stage renal disease that are projected to undergo hemodialysis. Unfortunately, AV shunt failure remains a significant clinical problem for hemodialysis patients. In general, the cause of most early AV shunt failure is still unknown, but the quality of the blood vessels is suspected as a factor. This study aimed to determine the correlation between blood vessel diameter and the success of AV shunt surgery. Methods: This study is a cross sectional study that uses a descriptive-analytic design. The samples were obtained from the patient’s medical records with the total sampling technique of all patients who have undergone AV shunt surgery from January 2019 – December 2020 at Dr. Soetomo General Hospital which matches the inclusion and exclusion criteria. Results: Patients’ blood vessel diameter measurement is divided into four categories which are <2 mm, 2 - <4 mm, 4 - <6 mm, and ≥6 mm. From a total of 62 patients, the highest successful surgery rate is carried out in patients with a vein diameter of 2 - <4 mm (77.59%) and artery diameter of 2 - <4 mm (63.79%). The results of the Chi-Square analysis found no significant correlation between vein diameter (p=0.769) or artery diameter (p=0.922) and the success of AV shunt surgery at Dr. Soetomo Hospital, Surabaya 2019-2020. Conclusions: In conclusion, this study did not find a correlation between the intraoperative blood vessel diameter and the technical success of AV shunt surgery.