Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up
Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand en...
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| Autor*in: |
Ferreira, Fabio Gonçalves [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2009 |
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| Schlagwörter: |
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| Anmerkung: |
© Société Internationale de Chirurgie 2009 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 33(2009), 10 vom: 13. Aug., Seite 2136-2143 |
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| Übergeordnetes Werk: |
volume:33 ; year:2009 ; number:10 ; day:13 ; month:08 ; pages:2136-2143 |
| Links: |
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| DOI / URN: |
10.1007/s00268-009-0196-y |
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SPR00342040X |
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| 100 | 1 | |a Ferreira, Fabio Gonçalves |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up |
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| 520 | |a Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication. | ||
| 650 | 4 | |a Portal Vein |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Blood Flow Velocity |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Portal Vein Thrombosis |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Esophagogastric Varix |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Portal Vein Flow |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Ribeiro, Maurício Alves |4 aut | |
| 700 | 1 | |a de Fátima Santos, Maria |4 aut | |
| 700 | 1 | |a Assef, José César |4 aut | |
| 700 | 1 | |a Szutan, Luiz Arnaldo |4 aut | |
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10.1007/s00268-009-0196-y doi (DE-627)SPR00342040X (SPR)s00268-009-0196-y-e DE-627 ger DE-627 rakwb eng Ferreira, Fabio Gonçalves verfasserin aut Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2009 Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication. Portal Vein (dpeaa)DE-He213 Blood Flow Velocity (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Esophagogastric Varix (dpeaa)DE-He213 Portal Vein Flow (dpeaa)DE-He213 Ribeiro, Maurício Alves aut de Fátima Santos, Maria aut Assef, José César aut Szutan, Luiz Arnaldo aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 33(2009), 10 vom: 13. Aug., Seite 2136-2143 (DE-627)SPR003391159 nnns volume:33 year:2009 number:10 day:13 month:08 pages:2136-2143 https://dx.doi.org/10.1007/s00268-009-0196-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 33 2009 10 13 08 2136-2143 |
| spelling |
10.1007/s00268-009-0196-y doi (DE-627)SPR00342040X (SPR)s00268-009-0196-y-e DE-627 ger DE-627 rakwb eng Ferreira, Fabio Gonçalves verfasserin aut Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2009 Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication. Portal Vein (dpeaa)DE-He213 Blood Flow Velocity (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Esophagogastric Varix (dpeaa)DE-He213 Portal Vein Flow (dpeaa)DE-He213 Ribeiro, Maurício Alves aut de Fátima Santos, Maria aut Assef, José César aut Szutan, Luiz Arnaldo aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 33(2009), 10 vom: 13. Aug., Seite 2136-2143 (DE-627)SPR003391159 nnns volume:33 year:2009 number:10 day:13 month:08 pages:2136-2143 https://dx.doi.org/10.1007/s00268-009-0196-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 33 2009 10 13 08 2136-2143 |
| allfields_unstemmed |
10.1007/s00268-009-0196-y doi (DE-627)SPR00342040X (SPR)s00268-009-0196-y-e DE-627 ger DE-627 rakwb eng Ferreira, Fabio Gonçalves verfasserin aut Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2009 Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication. Portal Vein (dpeaa)DE-He213 Blood Flow Velocity (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Esophagogastric Varix (dpeaa)DE-He213 Portal Vein Flow (dpeaa)DE-He213 Ribeiro, Maurício Alves aut de Fátima Santos, Maria aut Assef, José César aut Szutan, Luiz Arnaldo aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 33(2009), 10 vom: 13. Aug., Seite 2136-2143 (DE-627)SPR003391159 nnns volume:33 year:2009 number:10 day:13 month:08 pages:2136-2143 https://dx.doi.org/10.1007/s00268-009-0196-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 33 2009 10 13 08 2136-2143 |
| allfieldsGer |
10.1007/s00268-009-0196-y doi (DE-627)SPR00342040X (SPR)s00268-009-0196-y-e DE-627 ger DE-627 rakwb eng Ferreira, Fabio Gonçalves verfasserin aut Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2009 Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication. Portal Vein (dpeaa)DE-He213 Blood Flow Velocity (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Esophagogastric Varix (dpeaa)DE-He213 Portal Vein Flow (dpeaa)DE-He213 Ribeiro, Maurício Alves aut de Fátima Santos, Maria aut Assef, José César aut Szutan, Luiz Arnaldo aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 33(2009), 10 vom: 13. Aug., Seite 2136-2143 (DE-627)SPR003391159 nnns volume:33 year:2009 number:10 day:13 month:08 pages:2136-2143 https://dx.doi.org/10.1007/s00268-009-0196-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 33 2009 10 13 08 2136-2143 |
| allfieldsSound |
10.1007/s00268-009-0196-y doi (DE-627)SPR00342040X (SPR)s00268-009-0196-y-e DE-627 ger DE-627 rakwb eng Ferreira, Fabio Gonçalves verfasserin aut Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2009 Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication. Portal Vein (dpeaa)DE-He213 Blood Flow Velocity (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Esophagogastric Varix (dpeaa)DE-He213 Portal Vein Flow (dpeaa)DE-He213 Ribeiro, Maurício Alves aut de Fátima Santos, Maria aut Assef, José César aut Szutan, Luiz Arnaldo aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 33(2009), 10 vom: 13. Aug., Seite 2136-2143 (DE-627)SPR003391159 nnns volume:33 year:2009 number:10 day:13 month:08 pages:2136-2143 https://dx.doi.org/10.1007/s00268-009-0196-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 33 2009 10 13 08 2136-2143 |
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There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Portal Vein</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Blood Flow Velocity</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Portal Vein Thrombosis</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Esophagogastric Varix</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Portal Vein Flow</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ribeiro, Maurício Alves</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">de Fátima Santos, Maria</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Assef, José César</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Szutan, Luiz Arnaldo</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">World Journal of Surgery</subfield><subfield code="d">Springer-Verlag, 1996</subfield><subfield code="g">33(2009), 10 vom: 13. 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Ferreira, Fabio Gonçalves |
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Ferreira, Fabio Gonçalves misc Portal Vein misc Blood Flow Velocity misc Portal Vein Thrombosis misc Esophagogastric Varix misc Portal Vein Flow Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up |
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Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up Portal Vein (dpeaa)DE-He213 Blood Flow Velocity (dpeaa)DE-He213 Portal Vein Thrombosis (dpeaa)DE-He213 Esophagogastric Varix (dpeaa)DE-He213 Portal Vein Flow (dpeaa)DE-He213 |
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Ferreira, Fabio Gonçalves Ribeiro, Maurício Alves de Fátima Santos, Maria Assef, José César Szutan, Luiz Arnaldo |
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doppler ultrasound could predict varices progression and rebleeding after portal hypertension surgery: lessons from 146 egds and 10 years of follow-up |
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Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow-Up |
| abstract |
Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication. © Société Internationale de Chirurgie 2009 |
| abstractGer |
Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication. © Société Internationale de Chirurgie 2009 |
| abstract_unstemmed |
Background Surgical treatment of variceal hemorrhagic complications for patients with schistosomal portal hypertension in our group comprised an esophagogastric devascularization procedure with splenectomy (EGDS). There are two different kinds of postoperative follow-up: prophylactic or on-demand endoscopic program of varices eradication. This program implies risks and costs and only proves necessary in 6–29% of cases. This study was designed to assess portal vein Doppler ultrasound data in these patients, and to verify correlations with progression in the number and size of varices, as well as the appearance of red spots and rebleeding during the postoperative period after EGDS. Methods Data on portal vein Doppler ultrasound from 146 patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture was analyzed. All subjects underwent EGDS and were analyzed before and after the procedure and compared postoperatively at four time points: 1 year, 2 years, up to 5 years, and up to 10 years. The following portal hemodynamic parameters were analyzed: diameter and mean blood flow velocity. Variceal size and number, presence of red spots, and rebleeding were all determined by endoscopic examination. Patients were divided into two groups at the each of the four time points, according to esophagogastric varices progression. Results Patients with variceal progression had significantly higher values of portal blood flow velocity. At time points I, II, III, and IV, the measured flow velocity from first postoperative year was 17.64 ± 4.84 vs. 13.81 ± 5.61 (p = 0.025); 16.74 ± 4.8 vs. 13.75 ± 5.8 (p = 0.039); 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036); and 16.01 ± 5.00 vs. 13.23 ± 5.86 (p = 0.036), respectively. Conclusions Patients with schistosomal portal hypertension submitted to EGDS who had portal blood flow velocity >15.5 cm per second at the first postoperative year ha d progression of esophagogastric varices and a greater chance of rebleeding and, therefore, should be included in the endoscopic program for varices eradication. © Société Internationale de Chirurgie 2009 |
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