title: Evolutional profile of the esophageal varices after splenectomy associated with ligation of the left gastric vein and sclerotherapy in schistosomal portal hypertension.
abstract: BACKGROUND
  The schistosomiasis affects 200 million people in 70 countries worldwide. It is estimated that 10% of those infected will develop hepatosplenic status and of these, 30% will progress to portal hypertension and esophagogastric varices, whose expression is through gastrointestinal bleeding with significant mortality in the first bleeding episode. Multiple surgical techniques have been developed to prevent re-bleeding.
  
  
  OBJECTIVE
  To evaluate the evolutional profile of esophageal varices after splenectomy + ligation of the left gastric vein associated with endoscopic sclerotherapy in schistosomal portal hypertension.
  
  
  METHODS
  Prospective and observational study including schistosomiasis patients with previous history of upper digestive hemorrhage and underwent to splenectomy + ligation of the left gastric vein and sclerotherapy. The variables were: evolutional profile of esophageal varices before and after surgery and re-bleeding rate.
  
  
  RESULTS
  The sample included 30 patients, 15 patients for each gender. The age ranged from 19 to 74 years (median = 43 years). There was a reduction in the degree, caliber and red spots in all patients (p< 0.05). The eradication of varices with sclerotherapy was achieved in 86.7% and with surgery alone in 15.4%. The mean follow-up was 28 months, ranging from two to 76 months. Were carried from one to seven sessions of sclerotherapy and the average was three per patient to eradicate varices. Four (13.3%) did not complete the follow-up. The re-bleeding rate was 16.7%.
  
  
  CONCLUSIONS
  There was a reduction of the degree, caliber and red spots of esophageal varices in all patients.
authors.affiliation: Group of Liver, Bile Ducts, Pancreas and Portal Hypertension Surgery, General Surgery and Specialties Service, University Hospital Prof. Alberto Antunes, Faculty of Medicine, Federal University of Alagoas, Maceio, Brazil. jbatista19@uol.com.br
authors.forename: João
authors.initials: J
authors.lastname: Batista-Neto
authors.forename: Luciano Becker
authors.initials: LB
authors.lastname: Tognetti
authors.forename: Laércio Tenório
authors.initials: LT
authors.lastname: Ribeiro
authors.forename: Maria do Carmo
authors.initials: Mdo C
authors.lastname: Balwani
authors.forename: Tadeu
authors.initials: T
authors.lastname: Muritiba
authors.forename: Elton Elton Correa
authors.initials: EE
authors.lastname: Alves
mesh_terms: D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000469:parasitology* / Q000628:therapy*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000469:parasitology* / Q000628:therapy*; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012555:Schistosomiasis mansoni / Q000628:therapy*; D015911:Sclerotherapy; D013156:Splenectomy; D013270:Stomach / Q000098:blood supply; D014680:Veins / Q000601:surgery; D055815:Young Adult