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血吸虫病患者行食管胃去血管化联合脾切除术并内镜治疗的远期结果

Late results of esophagogastric devascularization and splenectomy associated with endoscopic treatment in patients with schistosomiasis.

作者信息

da Silva-Neto Walter De Biase, Quireze-Júnior Claudemiro, Tredicci Thiago Miranda

机构信息

Departamento de Clínica Cirúrgica, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brazil.

出版信息

Arq Bras Cir Dig. 2015 Jul-Sep;28(3):197-9. doi: 10.1590/S0102-67202015000300013.

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 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.

摘要

背景

血吸虫病在巴西是一个地方性问题,影响约300万至400万人,食管静脉曲张破裂引起的消化道出血是该疾病的主要并发症。手术治疗已成为一种治疗选择,特别是对于至少发生过一次出血后的二级预防。绝大多数外科医生用于预防再出血的手术技术是食管胃去血管化和脾切除术。尽管术后效果良好,但再出血率仍然很高,这表明所有患者都需要进行内镜随访。

目的

评估接受食管胃去血管化和脾切除术以及术后内镜治疗的患者在食管静脉曲张管径和再出血率方面的长期结果。

方法

对12例行食管胃去血管化和脾切除术并随访超过5年的患者进行回顾性研究。

结果

所有患者的静脉曲张大小均减小,且无患者术后出血复发。

结论

食管胃去血管化和脾切除术与内镜随访相结合时,可显著减小食管静脉曲张的大小,对预防出血复发有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5144/4737362/47a5983c5d25/0102-6720-abcd-28-03-00197-gf1.jpg

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