| Revista: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000407200 |
| ISSN: | 1665-2681 |
| Autores: | Lacet, Celina Maria Costa1 Batista-Neto, Joao1 Ribeiro, Laercio Tenorio1 Oliveira, Francisco Silva1 Wyszomirska, Rozangela Fernandes1 Strauss, Edna1 |
| Instituciones: | 1Universidade Federal de Alagoas, Hospital Universitario Professor Alberto Antunes, Maceio, Alagoas. Brasil |
| Año: | 2016 |
| Periodo: | Sep-Oct |
| Volumen: | 15 |
| Número: | 5 |
| Paginación: | 738-744 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | Upper gastrointestinal bleeding is a major cause of morbidity and mortality in patients with portal hypertension secondary to schistosomiasis mansoni. Aim. To Aim. evaluate the efficacy of combined surgery and sclerotherapy versus endoscopic treatment alone in the prophylaxis of esophageal variceal rebleeding due to portal hypertension in schistosomiasis. Material and methods. methods. methods. During a two-years period consecutive patients with schistosomiasis and a recent bleeding history were evaluated for prospective randomization. Absolute exclusion criteria were alcoholism or other liver diseases, whereas platelet count < 50,000/mm3 , INR > 1.5 or presence of gastric varices were relative exclusion criteria. By random allocation 25 (group A) have received endoscopic sclerotherapy for esophageal varices alone and 22 (group B) combined treatment: esophagogastric devascularization with splenectomy followed by sclerotherapy. Interim analysis at 24 months has shown significant statistical differences between the groups and the randomization was halted. Results. Results. Results. Mean age was 38.9 ± 15.4 years and 58.46% were male. Mean follow-up was 38.6 ± 20.1 months. Endoscopic comparison of the size of esophageal varices before and after treatment did not show significant differences among the two groups. Treatment efficacy was assessed by the rate of recurrent esophageal variceal bleeding, that was more common in group A- 9/25 patients (36.0%) vs. 2/22 (9.0%) in group B (p = 0.029). Other complications were odynophagia, dysphagia and esophageal ulcer in group A and ascites and portal vein thrombosis in the surgical group. Conclusion. Conclusion. In portal hypertension due to schistosomiasis, combined surgical and endoscopic treatment was more effective for the prevention of recurrent esophageal variceal bleeding |
| Disciplinas: | Medicina |
| Palabras clave: | Cirugía, Gastroenterología, Parasitología, Esquistosomiasis, Hipertensión portal, Sangrado digestivo, Escleroterapia, Esplenectomía, Endoscopia |
| Keyword: | Medicine, Gastroenterology, Surgery, Parasitology, Schistosomiasis, Portal hypertension, Digestive bleeding, Sclerotherapy, Splenectomy, Endoscopy |
| Texto completo: | Texto completo (Ver PDF) |
