Late results of esophagogastric devascularization and splenectomy associated with endoscopic treatment in patients with schistosomiasis.

Abstract

Background:Schistosomiasis is endemic problem in Brazil affecting about three to four million people, and digestive hemorrhage caused by esophageal varices rupture is the main complication of the disease. Surgical treatment has become a therapeutic option, especially for secondary prophylaxis after at least one episode of bleeding. The surgical technique used by the vast majority of surgeons for the prevention of rebleeding is esophagogastric devascularization and splenectomy. Although with good postoperative results, rebleeding rate is significant, showing the need to follow-up endoscopy in all patients. Aim:To evaluate long-term results of patients submitted to esophagogastric devascularization and splenectomy and postoperative endoscopic treatment regarding esophageal varices caliber and rebleeding rates. Methods:A retrospective study of 12 patients underwent esophagogastric devascularization and splenectomy followed for more than five years. Results: All patients showed varices size reduction, and no patient had postoperative bleeding recurrence. Conclusion:Esophagogastric devascularization and splenectomy decreased significantly the esophageal variceal size when associated with endoscopic follow-up, being effective for bleeding recurrence prophylaxis.