Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertension
Autor(a) principal: | |
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Data de Publicação: | 1999 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Hospital das Clínicas |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87811999000600005 |
Resumo: | The size of gastroesophageal varices is one of the most important factors leading to hemorrhage related to portal hypertension. An endoscopic evaluation of the size of gastroesophageal varices before and after different operations for portal hypertension was performed in 73 patients with schistosomiasis, as part of a randomized trial: proximal splenorenal shunt (PSS n=24), distal splenorenal shunt (DSS n=24), and esophagogastric devascularization with splenectomy (EGDS n=25). The endoscopic evaluation was performed before and up to 10 years after the operations. Variceal size was graded according to Palmer's classification: grade 1 -- up to 3 mm, grade 2 -- from 3 to 6 mm, grade 3 -- greater than 6 mm, and were analyzed in four anatomical locations: inferior, middle or superior third of the esophagus, and proximal stomach. The total number of points in the pre-operative grading minus the number of points in the post-operative grading gave a differential grading, allowing statistical comparison among the surgical groups. Good results, in terms of disappearance or decrease of variceal size, were observed more frequently after PSS than after DSS or EGDS - 95.8%, 83.3%, and 72%, respectively. When differential grading was analyzed, a statistically significant difference was observed between PSS and EGDS, but not between proximal and distal splenorenal shunts. In conclusion, shunt surgeries were more efficient than devascularization in diminishing variceal size. |
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Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertensionHepatosplenic SchistosomiasisPortal hypertensionEsophageal varicesSurgical treatmentVariceal sizeThe size of gastroesophageal varices is one of the most important factors leading to hemorrhage related to portal hypertension. An endoscopic evaluation of the size of gastroesophageal varices before and after different operations for portal hypertension was performed in 73 patients with schistosomiasis, as part of a randomized trial: proximal splenorenal shunt (PSS n=24), distal splenorenal shunt (DSS n=24), and esophagogastric devascularization with splenectomy (EGDS n=25). The endoscopic evaluation was performed before and up to 10 years after the operations. Variceal size was graded according to Palmer's classification: grade 1 -- up to 3 mm, grade 2 -- from 3 to 6 mm, grade 3 -- greater than 6 mm, and were analyzed in four anatomical locations: inferior, middle or superior third of the esophagus, and proximal stomach. The total number of points in the pre-operative grading minus the number of points in the post-operative grading gave a differential grading, allowing statistical comparison among the surgical groups. Good results, in terms of disappearance or decrease of variceal size, were observed more frequently after PSS than after DSS or EGDS - 95.8%, 83.3%, and 72%, respectively. When differential grading was analyzed, a statistically significant difference was observed between PSS and EGDS, but not between proximal and distal splenorenal shunts. In conclusion, shunt surgeries were more efficient than devascularization in diminishing variceal size.Faculdade de Medicina / Universidade de São Paulo - FM/USP1999-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87811999000600005Revista do Hospital das Clínicas v.54 n.6 1999reponame:Revista do Hospital das Clínicasinstname:Universidade de São Paulo (USP)instacron:USP10.1590/S0041-87811999000600005info:eu-repo/semantics/openAccessStrauss,EdnaSakai,PauloGayotto,Luiz Carlos da CostaCardoso,Rita AntonelliForster,SoniaRaia,Silvanoeng2000-07-20T00:00:00Zoai:scielo:S0041-87811999000600005Revistahttp://www.scielo.br/rhcPUBhttps://old.scielo.br/oai/scielo-oai.php||revista.hc@hcnet.usp.br1678-99030041-8781opendoar:2000-07-20T00:00Revista do Hospital das Clínicas - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertension |
title |
Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertension |
spellingShingle |
Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertension Strauss,Edna Hepatosplenic Schistosomiasis Portal hypertension Esophageal varices Surgical treatment Variceal size |
title_short |
Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertension |
title_full |
Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertension |
title_fullStr |
Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertension |
title_full_unstemmed |
Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertension |
title_sort |
Size of gastroesophageal varices: its behavior after the surgical treatment of portal hypertension |
author |
Strauss,Edna |
author_facet |
Strauss,Edna Sakai,Paulo Gayotto,Luiz Carlos da Costa Cardoso,Rita Antonelli Forster,Sonia Raia,Silvano |
author_role |
author |
author2 |
Sakai,Paulo Gayotto,Luiz Carlos da Costa Cardoso,Rita Antonelli Forster,Sonia Raia,Silvano |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Strauss,Edna Sakai,Paulo Gayotto,Luiz Carlos da Costa Cardoso,Rita Antonelli Forster,Sonia Raia,Silvano |
dc.subject.por.fl_str_mv |
Hepatosplenic Schistosomiasis Portal hypertension Esophageal varices Surgical treatment Variceal size |
topic |
Hepatosplenic Schistosomiasis Portal hypertension Esophageal varices Surgical treatment Variceal size |
description |
The size of gastroesophageal varices is one of the most important factors leading to hemorrhage related to portal hypertension. An endoscopic evaluation of the size of gastroesophageal varices before and after different operations for portal hypertension was performed in 73 patients with schistosomiasis, as part of a randomized trial: proximal splenorenal shunt (PSS n=24), distal splenorenal shunt (DSS n=24), and esophagogastric devascularization with splenectomy (EGDS n=25). The endoscopic evaluation was performed before and up to 10 years after the operations. Variceal size was graded according to Palmer's classification: grade 1 -- up to 3 mm, grade 2 -- from 3 to 6 mm, grade 3 -- greater than 6 mm, and were analyzed in four anatomical locations: inferior, middle or superior third of the esophagus, and proximal stomach. The total number of points in the pre-operative grading minus the number of points in the post-operative grading gave a differential grading, allowing statistical comparison among the surgical groups. Good results, in terms of disappearance or decrease of variceal size, were observed more frequently after PSS than after DSS or EGDS - 95.8%, 83.3%, and 72%, respectively. When differential grading was analyzed, a statistically significant difference was observed between PSS and EGDS, but not between proximal and distal splenorenal shunts. In conclusion, shunt surgeries were more efficient than devascularization in diminishing variceal size. |
publishDate |
1999 |
dc.date.none.fl_str_mv |
1999-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87811999000600005 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87811999000600005 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0041-87811999000600005 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Faculdade de Medicina / Universidade de São Paulo - FM/USP |
publisher.none.fl_str_mv |
Faculdade de Medicina / Universidade de São Paulo - FM/USP |
dc.source.none.fl_str_mv |
Revista do Hospital das Clínicas v.54 n.6 1999 reponame:Revista do Hospital das Clínicas instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista do Hospital das Clínicas |
collection |
Revista do Hospital das Clínicas |
repository.name.fl_str_mv |
Revista do Hospital das Clínicas - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||revista.hc@hcnet.usp.br |
_version_ |
1754820894008541184 |