Past and present of portal hypertension surgery (about the Rostov school of surgeons)

Objective: to analyze the accumulated experience of the Rostov surgical school in providing care to patients with complicated portal hypertension, to discuss and present the author's view on the facts presented. Materials and methods: the surgical clinic of Rostov State Medical University has experience in treating more than 500 patients with cirrhosis of the liver since 1993. The stages of mastering surgical interventions began with the work of N.A. Bogoraz, who moved from the University of Warsaw to Rostov-on-Don. By 2007, 79 operations of proximal splenorenal (splenotesticular) venous bypass surgery (group I) were performed, from 2007 to 2024 315 operations of transjugular intrahepatic portosystemic bypass surgery (group II). Results: analysis of intra- and postoperative complications revealed that intra-abdominal bleeding was registered in 5,06% in group I versus 0.31% in group II; varicose esophageal and gastric bleeding in the first 24 hours after surgery in 2,53% versus the absence of such a complication in group II, anemia after surgery requiring hemotransfusion in 34.17% against 0%, the development of hepatorenal syndrome in 7,59%, which led to death in group I versus 2,53% in group II. Conclusions: the Rostov Surgical School, which is one of the five centers in the Russian Federation that widely use TIPS/TIPS surgery in their arsenal, makes a definite contribution to improving the technique. But the issue of providing high-tech medical care to patients with cirrhosis of the liver remains open in its knowledge and development.

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