SINGLE-CENTER EXPERIENCE WITH REX SHUNT IN CHILDREN WITH EXTRAHEPATIC PORTAL VEIN THROMBOSIS

Gür Ş., Ulusoy O., Ateş O., Hakgüder F. G., Olguner M., Akgür M. F.

43. Ulusal Çocuk Cerrahisi kongresi ve Mısır Çocuk Cerrahisi ortak kongresi, İstanbul, Türkiye, 21 - 24 Ekim 2026, ss.57-58, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: İstanbul
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.57-58
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Objective: Extrahepatic portal vein thrombosis (EHPVT) is one of the leading causes of portal hypertension in children.

The Rex shunt is considered a physiological surgical procedure that restores hepatopetal portal blood flow. This study

aimed to evaluate the clinical characteristics and early surgical outcomes of pediatric patients who underwent Rex

shunt for EHPVT at our center.

Materials and Methods: Pediatric patients who underwent Rex shunt at our institution between 1999 and 2026 were

retrospectively reviewed. Demographic characteristics, associated comorbidities, preoperative imaging findings,

endoscopic variceal grades, graft type, portal vein patency, Doppler ultrasonography findings, hematological parameters,

and early postoperative outcomes were evaluated.

Results: A total of 9 patients (3 males and 6 females) were included in the study. The mean age at surgery was 7.6 ±

5.0 years (range, 14 months–15 years). One patient had protein C/S deficiency, one had a horseshoe kidney, one had

an accessory spleen, and two had associated cardiac anomalies. A history of umbilical vein catheterization during

the neonatal period was present in five patients (55.5%). Preoperative endoscopy demonstrated esophageal varices

ranging from Grade 1 to Grade 3. The inferior mesenteric vein was used as the graft in four patients, whereas the left

internal jugular vein was used in five patients. Portal venous continuity was successfully restored in all patients with

suitable vascular anatomy. In the early postoperative period, graft patency was confirmed by Doppler ultrasonography,

and no major surgical complications were observed.

Conclusion: Rex shunt is an effective and safe surgical procedure for restoring physiological portal venous circulation in

children with EHPVT. Although our series is limited by the small number of patients, our early outcomes are consistent

with those reported in the literature. Larger patient cohorts and long-term follow-up studies are needed to further

evaluate the efficacy of this procedure.