Pre- and postoperative systemic hemodynamic evaluation in patients subjected to esophagogastric devascularization plus splenectomy and distal splenorenal shunt: A comparative study in schistomomal portal hypertension

Cleva, Roberto de; Herman, Paulo; D’Albuquerque, Luiz Augusto Carneiro; Pugliese, Vincenzo; Santarém, Orlando Luis de Andrade; Saad, William Abrão

doi:10.3748/wjg.v13.i41.5471

Cited by 41 publications

(28 citation statements)

References 23 publications

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“…This syndrome generally results in two severe complications: bleeding from esophagogastric varices and thrombocytopenia due to hypersplenism. The combination of splenectomy and esophagogastric devascularization (ED) is an efficacious surgical procedure for portal hypertension [3,4], because these two major problems can be solved at the same time [5]. Recently, some significant advances in laparoscopy equipment and skill have enabled total laparoscopic splenectomy (LS) + ED [6].…”

Section: Introductionmentioning

confidence: 99%

Total Laparoscopic versus Open Splenectomy and Esophagogastric Devascularization in the Management of Portal Hypertension: A Comparative Study

Zheng

Liu

Yao³

2009

Dig Surg

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Background/Aim: Total laparoscopic splenectomy (LS) + esophagogastric devascularization (ED) has been accepted as a safe treatment for patients with portal hypertension and serious gastroesophageal varices in China. This study was carried out to determine whether total LS + ED is more advantageous than the open procedure in the management of portal hypertension. Methods: From February 2007 to July 2008, 24 patients were diagnosed with portal hypertension and serious gastroesophageal varices in our center. Seven patients underwent total LS + ED and 17 patients received the open procedure. Results and outcomes were compared retrospectively. Results: All operations were performed successfully. The operative time was similar in both groups (p = 0.355 > 0.05). The intraoperative blood loss was obviously less in the laparoscopic group (p = 0.001 < 0.05). Postoperative hospital stay was not different among the groups (p = 0.079 > 0.05), but this was mainly due to one complicated case in the laparoscopic group. Conclusions: Although LS + ED entails meticulous technical preparation, it has the advantage of minimally invasive surgery and offers a good alternative for the management of portal hypertension.

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Section: Introductionmentioning

confidence: 99%

Total Laparoscopic versus Open Splenectomy and Esophagogastric Devascularization in the Management of Portal Hypertension: A Comparative Study

Zheng

Liu

Yao³

2009

Dig Surg

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“…Considering the severity of previous bleeding episodes and the high recurrence rate in a short interval of time, moreover the high incidence of large esophageal varices and the presence of red spots, treatment should be aggressive to avoid bleeding recurrence. The majority of groups that lead with the disease employ esophagogastric devascularization (azigo-portal disconnection) and splenectomy as the preferred surgical treatment 5,6,8,11,14 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of patients with schistosomal portal hypertension treated in a tertiary hospital

Makdissi¹,

Herman²,

Colaneri³

et al. 2009

ABCD, arq. bras. cir. dig.

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BACKGROUND: Schistosomiasis is an important public health issue in more than 70 countries around the world. About 600 million people are at risk to acquire the parasite and there are 200 million infected worldwide. AIM: To evaluate the characteristics of schistosomal portal hypertension individuals who underwent previous esophageal varices bleeding treated in a tertiary hospital. METHODS: The records of 155 patients were evaluated and clinical, laboratorial, endoscopic, epidemiological features and hemorrhagic event severity were analyzed to individualize this population. RESULTS: Mean age was 37.2 years and no clinical signs of hepatic failure were observed. Serum laboratory tests to evaluate liver function were normal or slightly alter. Anemia was present in 70 %, leucopenia in 75 % and thrombocytopenia in 86 % of the patients. At endoscopic evaluation varices were classified as grade III and IV in 91.3 %; red spots were observed in 40.3 % and congestive gastropathy in 13.6 %. Patients presented a mean of 2.8 previous episodes of variceal hemorrhage and, in 75 % with hemodynamic instability. CONCLUSIONS: Patients with schistosomal portal hypertension and history of upper digestive bleeding from esophageal varices are young individuals, without either clinical or laboratorial evidence of liver dysfunction, that present high morbidity due to the severity of the acute event of bleeding.

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“…To date, several studies, including randomized controlled trials (RCTs), have compared the outcomes of devascularization and shunt (25)(26)(27)(28) . However, The role of shunt and devascularization in portal hypertension still a topic of debate (29) . These surgical shunts have their own limitations like availability of the veins, requires longer operative time than devascularistion which is main concern in hemodynamically compromised patients, surgical expertise, preoperative angiography to declineate anatomy abdominal vessels and higher risk of shunt thrombosis (30)(31)(32)(33) .…”

Section: Discussionmentioning

confidence: 99%

Devascularization for Portal Hypertension not Obsolete: Technical Details and Experience of 104 Cases

Ali¹

2017

jmscr

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Pre- and postoperative systemic hemodynamic evaluation in patients subjected to esophagogastric devascularization plus splenectomy and distal splenorenal shunt: A comparative study in schistomomal portal hypertension

Cited by 41 publications

References 23 publications

Total Laparoscopic versus Open Splenectomy and Esophagogastric Devascularization in the Management of Portal Hypertension: A Comparative Study

Total Laparoscopic versus Open Splenectomy and Esophagogastric Devascularization in the Management of Portal Hypertension: A Comparative Study

Evaluation of patients with schistosomal portal hypertension treated in a tertiary hospital

Devascularization for Portal Hypertension not Obsolete: Technical Details and Experience of 104 Cases

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