Document Detail


Long-term results of esophagogastric devascularization and splenectomy associated with endoscopic treatment in schistosomal portal hypertension.
MedLine Citation:
PMID:  20645097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Esophagogastric devascularization and splenectomy (EGDS) is the most performed operation for prophylaxis of esophageal varices bleeding recurrence in hepatosplenic schistosomiasis. Lower rebleeding rates are obtained through the association of postoperative endoscopic treatment; however, there is a dearth of studies showing long-term results.
METHODS: Clinical, laboratory, and endoscopic data of 97 patients submitted to EGDS with at least 5 years of follow-up, were analyzed.
RESULTS: The mean follow-up was 116.4 months. Bleeding recurrence occurred in 24.7% of patients; however, this percentage was 14.6% when only variceal hemorrhage was considered. Bleeding recurrence occurred in four patients even after endoscopic evaluation demonstrated esophageal varices eradication. In the late follow-up we observed normalization of anemia, leukopenia, thrombocytopenia, hyperbilirubinemia, and a prothrombin activity time increase. No clinical or laboratory hepatic insufficiency was observed.
CONCLUSIONS: The EGDS procedure with postoperative endoscopic treatment led to good clinical results and avoided hemorrhagic recurrence in 75.3% of schistosomal patients. There was improvement of laboratory measures of hepatic function, as well as correction of hypersplenism. Variceal hemorrhagic recurrence may occur even when esophageal varices eradication is reached.
Authors:
Fabio Ferrari Makdissi; Paulo Herman; Vincenzo Pugliese; Roberto de Cleva; William Abrão Saad; Ivan Cecconello; Luiz Augusto Carneiro D'Albuquerque
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  34     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2011-03-17     Revised Date:  2014-06-06    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2682-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Esophageal and Gastric Varices / etiology,  therapy
Esophagus / blood supply,  surgery*
Female
Follow-Up Studies
Hemorrhage / etiology,  therapy*
Humans
Hypertension, Portal / etiology,  therapy*
Male
Middle Aged
Recurrence / prevention & control
Schistosomiasis / complications*
Splenectomy*
Stomach / blood supply,  surgery*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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