[Splenectomy plus left gastric vein ligature and devascularization of the great curvature of the stomach in the treatment of hepatosplenic schistosomiasis. Postoperative endoscopic sclerosis is necessary?].
OBJECTIVE
With the intention of evaluating the effectiveness and the maintenance of the postoperative endoscopic sclerosis as routine, in association to splenectomy with left gastric vein ligature and devascularization of the great curvature of the stomach, the present study was accomplished.


METHODS
Between 1992 and 1998, 131 patient were operated in the General Division of the "Hospital das Clínicas" (Federal University of Pernambuco, Recife, PE, Brazil). The medium follow-up was 30 months. All patients were requested to come back to the clinic for accomplishment of clinical and laboratory control. Of the 111 patients that came back to the clinic, 80 patients had a digestive endoscopy done. Of these 80 patients, 36 followed the recommendation and underwent to a postoperative endoscopic sclerosis program (group 1), while 44 did not accomplish postoperative endoscopic sclerosis (group 2).


RESULTS
Regarding the eradication of the esophagus varices, the authors found a statistical difference between the groups (52.7% of the group 1 vs. 18.2% of the group 2). Other analyzed items (mortality, rebleeding rate, thrombosis of the portal vein, gastric varices and degree of periportal fibrosis) statistical relevance was not observed.


CONCLUSIONS
The association of the postoperative endoscopic sclerosis to the splenectomy with left gastric vein ligature and devascularization of the great curvature of the stomach, in the treatment of schistosomotic portal hypertension with digestive hemorrhage antecedent, should be maintained.
Ferraz
A A
AA
Departamento de Cirurgia da Universidade Federal de Pernambuco (UFPE). aabf@truenet.com.br
Lopes
E P
EP
Barros
F M
FM
Sette
M J
MJ
Arruda
S M
SM
Ferraz
E M
EM
D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008109:Liver Diseases, Parasitic / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012555:Schistosomiasis mansoni / Q000150:complications / Q000601:surgery*; D015911:Sclerotherapy / Q000379:methods*; D013156:Splenectomy / Q000379:methods; D013158:Splenic Diseases / Q000469:parasitology / Q000601:surgery*; D013270:Stomach / Q000098:blood supply; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery