Abstract
Background: Extrahepatic portal vein obstruction (EHPVO) has been associated with growth impairment in children. We hypothesized that growth parameters improve after reversal of portal hypertension and restoration of mesenteric venous blood flow to the liver by the mesenterico-left portal vein bypass (MLPVB). Methods: A retrospective review of 45 children with idiopathic EHPVO who underwent MLPVB between 1997 and 2007 and had follow-up data for analysis was carried out. Growth was assessed using SD scores (z scores) for height, weight, and body mass index (BMI) at the time of operation and at early (5-12 months) and late (13-24 months) follow-up. Results: The mean height and weight of children with EHPVO was significantly lower than the general population before surgery. Mean BMI was also lower, although statistically insignificant. All parameters increased significantly after MLPVB as follows: height from -0.42 before surgery to -0.12 (P = .027) at 5 to 12 months and -0.14 (P = .026) at 13 to 24 months; weight from -0.49 before surgery to 0.03 (P < .001) at 5 to 12 months and 0.35 (P < .001) at 13 to 24 months; and BMI from -0.22 before surgery to 0.17 (P = .001) at 5 to 12 months and 0.48 (P < .001) at 13 to 24 months. Conclusion: Restoration of portal blood flow to the liver by MLPVB improves growth in children with EHPVO.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2067-2070 |
| Number of pages | 4 |
| Journal | Journal of Pediatric Surgery |
| Volume | 44 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2009 |
Fingerprint
Keywords
- Body mass index
- Mesenterico-left portal vein bypass
- Portal vein obstruction
- Portal vein thrombosis
- Rex shunt
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Surgery
Cite this
}
Growth impairment in children with extrahepatic portal vein obstruction is improved by mesenterico-left portal vein bypass. / Lautz, Timothy B; Sundaram, Shikha S.; Whitington, Peter F; Keys, Lisa; Superina, Riccardo A.
In: Journal of Pediatric Surgery, Vol. 44, No. 11, 01.11.2009, p. 2067-2070.Research output: Contribution to journal › Article
TY - JOUR
T1 - Growth impairment in children with extrahepatic portal vein obstruction is improved by mesenterico-left portal vein bypass
AU - Lautz, Timothy B
AU - Sundaram, Shikha S.
AU - Whitington, Peter F
AU - Keys, Lisa
AU - Superina, Riccardo A
PY - 2009/11/1
Y1 - 2009/11/1
N2 - Background: Extrahepatic portal vein obstruction (EHPVO) has been associated with growth impairment in children. We hypothesized that growth parameters improve after reversal of portal hypertension and restoration of mesenteric venous blood flow to the liver by the mesenterico-left portal vein bypass (MLPVB). Methods: A retrospective review of 45 children with idiopathic EHPVO who underwent MLPVB between 1997 and 2007 and had follow-up data for analysis was carried out. Growth was assessed using SD scores (z scores) for height, weight, and body mass index (BMI) at the time of operation and at early (5-12 months) and late (13-24 months) follow-up. Results: The mean height and weight of children with EHPVO was significantly lower than the general population before surgery. Mean BMI was also lower, although statistically insignificant. All parameters increased significantly after MLPVB as follows: height from -0.42 before surgery to -0.12 (P = .027) at 5 to 12 months and -0.14 (P = .026) at 13 to 24 months; weight from -0.49 before surgery to 0.03 (P < .001) at 5 to 12 months and 0.35 (P < .001) at 13 to 24 months; and BMI from -0.22 before surgery to 0.17 (P = .001) at 5 to 12 months and 0.48 (P < .001) at 13 to 24 months. Conclusion: Restoration of portal blood flow to the liver by MLPVB improves growth in children with EHPVO.
AB - Background: Extrahepatic portal vein obstruction (EHPVO) has been associated with growth impairment in children. We hypothesized that growth parameters improve after reversal of portal hypertension and restoration of mesenteric venous blood flow to the liver by the mesenterico-left portal vein bypass (MLPVB). Methods: A retrospective review of 45 children with idiopathic EHPVO who underwent MLPVB between 1997 and 2007 and had follow-up data for analysis was carried out. Growth was assessed using SD scores (z scores) for height, weight, and body mass index (BMI) at the time of operation and at early (5-12 months) and late (13-24 months) follow-up. Results: The mean height and weight of children with EHPVO was significantly lower than the general population before surgery. Mean BMI was also lower, although statistically insignificant. All parameters increased significantly after MLPVB as follows: height from -0.42 before surgery to -0.12 (P = .027) at 5 to 12 months and -0.14 (P = .026) at 13 to 24 months; weight from -0.49 before surgery to 0.03 (P < .001) at 5 to 12 months and 0.35 (P < .001) at 13 to 24 months; and BMI from -0.22 before surgery to 0.17 (P = .001) at 5 to 12 months and 0.48 (P < .001) at 13 to 24 months. Conclusion: Restoration of portal blood flow to the liver by MLPVB improves growth in children with EHPVO.
KW - Body mass index
KW - Mesenterico-left portal vein bypass
KW - Portal vein obstruction
KW - Portal vein thrombosis
KW - Rex shunt
UR - http://www.scopus.com/inward/record.url?scp=70450104018&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70450104018&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2009.05.016
DO - 10.1016/j.jpedsurg.2009.05.016
M3 - Article
VL - 44
SP - 2067
EP - 2070
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 11
ER -