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Lukina E.A.
National Research Center for Hematology Russian Academy of Medical Sciences
Danishyan K.I.
National Medical Research Center for Hematology
Extrahepatic portal hypertension in myeloproliferative diseases, features of diagnosis and therapeutic tactics
Journal: Endoscopic Surgery. 2024;30(1): 67‑79
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To cite this article:
Batrov PA, Lukina EA, Danishyan KI, Kitsenko EA. Extrahepatic portal hypertension in myeloproliferative diseases, features of diagnosis and therapeutic tactics. Endoscopic Surgery.
2024;30(1):67‑79. (In Russ.)
https://doi.org/10.17116/endoskop20243001167
Myeloproliferative diseases are clonal diseases that occur at the level of a hematopoietic stem cell, characterized by the proliferation of one or more myelopoiesis cell lines in the bone marrow with signs of preserved terminal differentiation, accompanied by changes in peripheral blood parameters. The incidence rate of myeloproliferative diseases is in the range of 1—5 cases per 100 thousand adults and varies depending on the nosological form. Typical complications of myeloproliferative diseases are venous thrombosis of various localizations. Among the latter, a special place is occupied by thrombosis of the portal system vessels, leading to the development of extrahepatic portal hypertension and the formation of varicose veins of the esophagus and stomach, requiring surgical treatment. To date, for the prevention of bleeding from varicose veins of the esophagus and stomach, such surgical aids as endoscopic ligation of varicose veins of the esophagus and stomach, endovascular methods of treatment, such as the technology of transjugular intrahepatic portosystemic shunt (TIPS), various types of portocaval shunting, which have limitations in performing in patients with myeloproliferative diseases and total thrombosis, are used vessels of the portal system. In this regard, splenectomy in addition to gastrotomy, stitching of varicose veins of the esophagus and stomach (operation of M.D. Patsiora’s) is an effective treatment method that significantly reduces the risk of life-threatening bleeding from varicose veins of the esophagus and stomach and, accordingly, increase the duration and quality of life of patients with myeloproliferative diseases. In accordance with this, an important role is played not only by the choice of an operational intervention.
Keywords:
Authors:
Lukina E.A.
National Research Center for Hematology Russian Academy of Medical Sciences
Danishyan K.I.
National Medical Research Center for Hematology
Received:
29.07.2023
Accepted:
06.09.2023
List of references:
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