2015
DOI: 10.1590/s0102-67202015000300013
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Abstract: 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 … Show more

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Cited by 5 publications
(7 citation statements)
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References 16 publications
(24 reference statements)
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“…Two major procedures have been widely applied, EGDS and distal splenorenal shunt. As the second option, a selective portal-systemic shunt, can lead to postoperative encephalopathy in up to 30% of patients, EGDS is the preferred technique performed in most groups for presinusoidal portal hypertension (6,8,12,17) . EGDS has the advantage of not triggering postoperative encephalopathy, but has the drawback of considerable rebleedling rates (up to 30%) from esophageal varices.…”
Section: Discussionmentioning
confidence: 99%
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“…Two major procedures have been widely applied, EGDS and distal splenorenal shunt. As the second option, a selective portal-systemic shunt, can lead to postoperative encephalopathy in up to 30% of patients, EGDS is the preferred technique performed in most groups for presinusoidal portal hypertension (6,8,12,17) . EGDS has the advantage of not triggering postoperative encephalopathy, but has the drawback of considerable rebleedling rates (up to 30%) from esophageal varices.…”
Section: Discussionmentioning
confidence: 99%
“…This procedure, leads to acceptable results regarding bleeding control without the disadvantage of hepatic encephalopathy in the postoperative period. Although leading to good postoperative results (8) , the rebleeding rate after EGDS is considerable, ranging from 6 to 29% (9,10,11,12) . Meanwhile, Sakai et al have shown a significant decrease in the postoperative bleeding rate when endoscopic therapy was associated in postoperative follow-up (12) , showing the need of a postoperative endoscopic program in patients submitted to EGDS (13,14) .…”
Section: Introductionmentioning
confidence: 99%
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“…Granted the heterogeneity of the reviewed studies for what concerns follow-up length and ancillary interventions (e.g., local management of varices), overall, DSRS appears being followed by fewer episodes of UGB compared to EGDS, but being burdened by a more frequent development of hepatic encephalopathy, with comparable mortality rates between the 2 interventions. When looking at the whole picture of results of the included studies presented in Fig 5, it seems that a better outcome in terms of rebleeding was reported when EGDS was followed by variceal sclerotherapy or band ligation [68][69][70], but no study included in this review formally compared EGDS alone versus EGDS followed by local variceal management. Such comparison was carried out by Ferraz and colleagues [71] who applied a variation of the EDGS procedure, including splenectomy, ligature of the left gastric vein, and devascularization of the great gastric curvature, without, however, finding significant differences in rebleeding rate between patients undergoing such technique followed or not by local variceal management sessions.…”
Section: "Classic" Surgical Interventionsmentioning
confidence: 99%
“…SS, statistically significant, NS, not statistically significant, NR, statistical analysis not reported. #n = intervention indicated in the corresponding "Intervention #n" to which the outcome direction refers[45,65,[67][68][69][70][71][72][73][80][81][82][83][84][85][86][87][88][89][90][91][92][93].…”
mentioning
confidence: 99%