Esclerose endoscópica das varizes esofágicas após tratamento cirúrgico da hipertensão portal em pacientes com esquistossomose hepatoesplênica

Sakai, Paulo

doi:10.1590/s0004-28032001000200001

Cited by 8 publications

(8 citation statements)

References 4 publications

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“…Moreover, there is no data supporting its role into rebleeding prevention. Looking for isolated endoscopic therapy, scleroterapy presents relapse of EGV in 60% of cases and rate of reebleding around 30% 35 . The BL seems offer better results and tolerance, however, there still no conclusive results for its isolated efficacy for rebleeding prophylaxis.…”

Section: Methodsmentioning

confidence: 99%

“…The EGDS has rebleeding rates in 5-16%, and mortality in 1-7%, but without any cases of encephalopathy since there is no blood deviation to systemic circulation 32 . Better results on rebleeding control are reached when endoscopic therapy is applied post-operatively to EGDS 26 , 35 . In this context, lower morbidity and mortality, absence of post-operative encephalopathy and good rebleeding control made the association of EGDS and post-operative endoscopic therapy as first choice in HSS patients.…”

Section: Methodsmentioning

confidence: 99%

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Management of variceal hemorrhage: current concepts

Coelho

Perini

Krüger

et al. 2014

ABCD, arq. bras. cir. dig.

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IntroductionThe treatment of portal hypertension is complex and the the best strategy depends on the underlying disease (cirrhosis vs. schistosomiasis), patient's clinical condition and time on it is performed (during an acute episode of variceal bleeding or electively, as pre-primary, primary or secondary prophylaxis). With the advent of new pharmacological options and technical development of endoscopy and interventional radiology treatment of portal hypertension has changed in recent decades.AimTo review the strategies employed in elective and emergency treatment of variceal bleeding in cirrhotic and schistosomotic patients.MethodsSurvey of publications in PubMed, Embase, Lilacs, SciELO and Cochrane databases through June 2013, using the headings: portal hypertension, esophageal and gastric varices, variceal bleeding, liver cirrhosis, schistosomiasis mansoni, surgical treatment, pharmacological treatment, secondary prophylaxis, primary prophylaxis, pre-primary prophylaxis.ConclusionPre-primary prophylaxis doesn't have specific treatment strategies; the best recommendation is treatment of the underlying disease. Primary prophylaxis should be performed in cirrhotic patients with beta-blockers or endoscopic variceal ligation. There is controversy regarding the effectiveness of primary prophylaxis in patients with schistosomiasis; when indicated, it is done with beta-blockers or endoscopic therapy in high-risk varices. Treatment of acute variceal bleeding is systematized in the literature, combination of vasoconstrictor drugs and endoscopic therapy, provided significant decline in mortality over the last decades. TIPS and surgical treatment are options as rescue therapy. Secondary prophylaxis plays a fundamental role in the reduction of recurrent bleeding, the best option in cirrhotic patients is the combination of pharmacological therapy with beta-blockers and endoscopic band ligation. TIPS or surgical treatment, are options for controlling rebleeding on failure of secondary prophylaxis. Despite the increasing evidence of the effectiveness of pharmacological and endoscopic treatment in schistosomotic patients, surgical therapy still plays an important role in secondary prophylaxis.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Management of variceal hemorrhage: current concepts

Coelho

Perini

Krüger

et al. 2014

ABCD, arq. bras. cir. dig.

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“…With the improvement of drug and endoscopic therapy in bleeding esophageal varices control, surgical treatment has become a therapeutic option 19 , especially for secondary prophylaxis after at least one episode of bleeding. As the patient with schistosomiasis has preserved liver function, the surgical technique used in the vast majority of groups for the prevention of rebleeding is esophagogastric devasculatrization and splenectomy (EGDS).…”

Section: Introductionmentioning

confidence: 99%

Late Results of Esophagogastric Devascularization and Splenectomy Associated With Endoscopic Treatment in Patients With Schistosomiasis

Silva-Neto

Junior

Tredicci

2015

ABCD, arq. bras. cir. dig.

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Background:Schistosomiasis is endemic problem in Brazil affecting about three to four million people, and digestive hemorrhage caused by esophageal varices rupture is the main complication of the disease. Surgical treatment has become a therapeutic option, especially for secondary prophylaxis after at least one episode of bleeding. The surgical technique used by the vast majority of surgeons for the prevention of rebleeding is esophagogastric devascularization and splenectomy. Although with good postoperative results, rebleeding rate is significant, showing the need to follow-up endoscopy in all patients. Aim:To evaluate long-term results of patients submitted to esophagogastric devascularization and splenectomy and postoperative endoscopic treatment regarding esophageal varices caliber and rebleeding rates. Methods:A retrospective study of 12 patients underwent esophagogastric devascularization and splenectomy followed for more than five years. Results: All patients showed varices size reduction, and no patient had postoperative bleeding recurrence. Conclusion:Esophagogastric devascularization and splenectomy decreased significantly the esophageal variceal size when associated with endoscopic follow-up, being effective for bleeding recurrence prophylaxis.

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“…Nenhuma complicação pós-operatória teve relação com a cateterização do ramo jejunal e colocação cateter no interior da veia porta. (POLLARA, 1992;FERRAZ et al, 1999) (SAKAI et al, 1990;SAKAI, 2001). No entanto, o índice de recidiva hemorrágica deste método quando utilizado de forma isolada em pacientes com esquistossomose forma hepato-esplênica situa-se entre 11 e 33,3% (AL-KARAWI et al, 1986;EL-ZAYADI et al, 1988;MOHAMED et al, 1989;CURY, 1990;CORDEIRO, 1990;SAKAI et al, 1990;AL-KARAWI et al, 1996) (CARNEIRO, 1979;ABRANTES et al, 1983;PITANGA, 1986;KARARA et al, 1987;BOIN, 1991;CAPUA et al, 1992;FERRAZ, 2000;GAWISH, et al, 2000).…”

Section: -Complicações Pós-operatóriasunclassified

“…Nenhum destes autores acima citados refere mortalidade nos episódios de ressangramento. Além disso, a escleroterapia endoscópica em pacientes submetidos a desconexão ázigo-portal e esplenectomia é mais efetiva que em pacientes sem cirurgia prévia (SAKAI, 2001), já que os vasos se apresentam com menor calibre, facilitando a ação do endoscopista. Isto talvez se deva ao fato de que a queda de pressão portal após a desconexão ázigo-portal mais esplenectomia demonstrada por alguns autores (POLLARA, 1992;CLEVA, 1996), é transferida para os vasos esofágicos, uma vez que as alterações na pressão portal apresentam valores equivalentes às da pressão ao nível das varizes esofágicas (MOSIMANN et al, 1983).…”

Section: -Complicações Pós-operatóriasunclassified

Avaliação intra-operatória da pressão portal e resultados do tratamento cirúrgico da hipertensão portal em pacientes esquistossomóticos

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Esclerose endoscópica das varizes esofágicas após tratamento cirúrgico da hipertensão portal em pacientes com esquistossomose hepatoesplênica

Cited by 8 publications

References 4 publications

Management of variceal hemorrhage: current concepts

Management of variceal hemorrhage: current concepts

Late Results of Esophagogastric Devascularization and Splenectomy Associated With Endoscopic Treatment in Patients With Schistosomiasis

Avaliação intra-operatória da pressão portal e resultados do tratamento cirúrgico da hipertensão portal em pacientes esquistossomóticos

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