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Growth impairment in children with extrahepatic portal vein obstruction is improved by mesenterico-left portal vein bypass.
J Pediatr Surg. 2009 Nov; 44(11):2067-70.JP

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.

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Authors+Show Affiliations

Lautz TB
Department of Surgery, Children's Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, IL 60611, USA. t-lautz@northwestern.edu
Sundaram SS
No affiliation info available
Whitington PF
No affiliation info available
Keys L
No affiliation info available
Superina RA
No affiliation info available

MeSH

AdolescentAnastomosis, SurgicalBody Mass IndexChildChild, PreschoolFemaleGrowth DisordersHumansHypertension, PortalInfantLiver CirculationMaleMesenteric VeinsPortal VeinPortasystemic Shunt, SurgicalRetrospective StudiesTreatment OutcomeVascular Surgical ProceduresVenous Thrombosis

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19944209

Citation

Lautz, Timothy B., et al. "Growth Impairment in Children With Extrahepatic Portal Vein Obstruction Is Improved By Mesenterico-left Portal Vein Bypass." Journal of Pediatric Surgery, vol. 44, no. 11, 2009, pp. 2067-70.
Lautz TB, Sundaram SS, Whitington PF, et al. Growth impairment in children with extrahepatic portal vein obstruction is improved by mesenterico-left portal vein bypass. J Pediatr Surg. 2009;44(11):2067-70.
Lautz, T. B., Sundaram, S. S., Whitington, P. F., Keys, L., & Superina, R. A. (2009). Growth impairment in children with extrahepatic portal vein obstruction is improved by mesenterico-left portal vein bypass. Journal of Pediatric Surgery, 44(11), 2067-70. https://doi.org/10.1016/j.jpedsurg.2009.05.016
Lautz TB, et al. Growth Impairment in Children With Extrahepatic Portal Vein Obstruction Is Improved By Mesenterico-left Portal Vein Bypass. J Pediatr Surg. 2009;44(11):2067-70. PubMed PMID: 19944209.
* Article titles in AMA citation format should be in sentence-case
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 - 2009/04/18/received PY - 2009/05/12/revised PY - 2009/05/13/accepted PY - 2009/12/1/entrez PY - 2009/12/1/pubmed PY - 2010/2/4/medline SP - 2067 EP - 70 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 44 IS - 11 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. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/19944209/Growth_impairment_in_children_with_extrahepatic_portal_vein_obstruction_is_improved_by_mesenterico_left_portal_vein_bypass_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(09)00412-6 DB - PRIME DP - Unbound Medicine ER -