Varizes de fundo gástrico na hipertensão portal esquistossomótica: resultados cirúrgicos

Ferraz, A.; Lopes, Edmundo Pessoa de Almeida; Júnior, José Guido Corrêa de Araújo; Lima, Bruno de Andrade; Cantarelli, Fabiano; Ferraz, Edmundo Machado

doi:10.1590/s0100-69912003000100005

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…Over four decades we continue following and defending these principles, evidently matching the pillars of thought with the available new technologies and newly acquired pathophysiological knowledge. Thus, since 1992 we perform splenectomy with ligation of left gastric vein associated with partial devascularization of the greater curvature of the stomach and subsequent endoscopic treatment of esophageal varices [1][2][3]17,18,20 . Splenectomy in hepatosplenic schistosomiasis with previous gastrointestinal bleeding requires a correction in the values of hematological alterations (anemia, leukocytes, lymphocytes, and platelets), and an average reduction of portal pressure of about 28% 15,27 -29 .…”

Section: Results Results Results Resultsmentioning

confidence: 99%

“…Surgical treatment of schistosomal portal hypertension followed the standard operations of general surgery at the Hospital das Clínicas, UFPE: stomach greater curvature devascularization, splenectomy, left gastric vein ligation, liver biopsy and postoperative endoscopic sclerosis of esophageal varices, 3,17,18,20 . When there were varices in the gastric fundus (64/169) we associated a routine opening of the stomach and suturing of the gastric fundus varices.…”

Section: Methods Methods Methods Methodsmentioning

confidence: 99%

“…Surgical treatment of schistosomal portal hypertension by splenectomy with ligation of left gastric vein, followed by postoperative endoscopic sclerosis is indicated in cases associated with prior upper gastrointestinal bleeding due to rupture of esophageal varices and/or gastric ulcers, or in cases of hypersplenism with important clinical consequences for the patient 1 In an attempt to identify risk factors that may compromise the postoperative outcome of patients undergoing surgery for disconnection and splenectomy, several authors have tried to preoperatively identify parameters that can improve late results in this group of patients, mainly with respect to rebleeding [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] .…”

Section: Introduction Introduction Introduction Introductionmentioning

confidence: 99%

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Influência da inversão do diâmetro veia porta/veia esplênica nos resultados do tratamento cirúrgico da hipertensão portal esquistossomótica

Aa¹,

et al. 2011

Rev. Col. Bras. Cir.

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Results: 169 patients were analyzed, with follow-up averaging 23.6 months. Twenty-one patients (12.4%) had splenic vein caliber greater of equal than the portal vein's (Inversion -study group). The mean preoperative diameter of the portal and splenic veins were respectively 1.49 and 1.14 cm in the control group, and 0.98 versus 1.07 cm in the inversion group. The portal vein diameter was significantly higher in the control group when compared to the inversion group (p <0.05). Varices in the gastric fundus were found in 33.3% of the inversion group and in 38.5% of patients in the control group. Postoperative rebleeding occurred in 23.1% of patients in the inversion group and in 13.4% of the control group ones (p> 0.05). In the postoperative evaluation with Doppler ultrasonography of portal vessels, no cases of portal vein thrombosis were observed in the inversion group, whilst in the control group portal thrombosis was identified in 16.9% of the patients (p <0.05). Death occurred in one (4.8%) individual from the inversion group; mortality was 4.1% in the control group (p>0.05). The mean serum level of platelets was significantly lower (65,950/mm³) in the inversion group than in the controls (106,647/mm³) (p<0.05). Conclusion: Conclusion: Conclusion: Conclusion: Conclusion: The results suggest that the reversal of portal/splenic vein caliber ratio does not represent a contraindication to surgical treatment of schistosomal portal hypertension.

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Section: Results Results Results Resultsmentioning

confidence: 99%

Section: Methods Methods Methods Methodsmentioning

confidence: 99%

Section: Introduction Introduction Introduction Introductionmentioning

confidence: 99%

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Influência da inversão do diâmetro veia porta/veia esplênica nos resultados do tratamento cirúrgico da hipertensão portal esquistossomótica

Aa¹,

et al. 2011

Rev. Col. Bras. Cir.

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“…The advantages of this technique are the relative ease to perform and direct access to gastric varices that are usually challenging in patients with PH. The gastric varices are present in 20% of PH cases, and they rise to 35% in HSS patients 16 . Gastric varices represent less than 2% of initial presentation of digestive bleeding, however their bleeding are more severe than esophageal varices.…”

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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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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“…Apesar de se verifi car redução de cerca de 50% no número de casos de esquistossomose mansônica (EM) no Brasil nas últimas duas décadas, assim como redução da taxa de mortalidade, a EM continua representando sério problema de saúde pública (6,13,26) . Formas graves da EM continuam a colocar em risco a vida dos pacientes.…”

Section: Introductionunclassified

Linfomas em pacientes com a forma hepatoesplênica da esquistossomose mansônica

Ferraz

Sá²,

Lopes³

et al. 2006

Arq. Gastroenterol.

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RESUMO -Racional -Cada vez mais se estabelece a correlação entre agentes infecciosos e doenças linfoproliferativas, sobretudo vírus e bactérias, através da ativação de linfócitos. Objetivo -Descrever 6 novos casos, de uma série de 254 pacientes (2,36%) com esquistossomose mansônica na forma hepatoesplênica. Casuística e métodos -São descritos 6 pacientes, dentre os 254 portadores de esquistossomose mansônica na forma hepatoesplênica, acompanhados nos últimos 13 anos no Serviço

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Varizes de fundo gástrico na hipertensão portal esquistossomótica: resultados cirúrgicos

Cited by 5 publications

References 13 publications

Influência da inversão do diâmetro veia porta/veia esplênica nos resultados do tratamento cirúrgico da hipertensão portal esquistossomótica

Influência da inversão do diâmetro veia porta/veia esplênica nos resultados do tratamento cirúrgico da hipertensão portal esquistossomótica

Management of variceal hemorrhage: current concepts

Linfomas em pacientes com a forma hepatoesplênica da esquistossomose mansônica

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