{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T03:42:05Z","timestamp":1704944525524},"reference-count":38,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2004,9]]},"abstract":"<jats:p>RACIONAL: No Brasil a principal causa de hipertens\u00e3o portal \u00e9 a esquistossomose mans\u00f4nica na sua forma hepatoespl\u00eanica. Com rela\u00e7\u00e3o ao seu tratamento, a prefer\u00eancia da maioria dos autores no Brasil recai sobre a desconex\u00e3o \u00e1zigo-portal e esplenectomia geralmente associada \u00e0 escleroterapia endosc\u00f3pica p\u00f3s-operat\u00f3ria para tratamento dessa enfermidade. No entanto, n\u00e3o est\u00e3o bem estabelecidas as altera\u00e7\u00f5es hemodin\u00e2micas portais decorrentes do tratamento cir\u00fargico da hipertens\u00e3o portal e sua influ\u00eancia no resultado desse tratamento. OBJETIVOS: Avaliar o impacto imediato da desconex\u00e3o \u00e1zigo-portal e esplenectomia na press\u00e3o portal e tamb\u00e9m os resultados do tratamento cir\u00fargico da hipertens\u00e3o portal no que se refere \u00e0 recidiva hemorr\u00e1gica e ao calibre das varizes de es\u00f4fago. CASU\u00cdSTICA E M\u00c9TODO: Foram estudados 19 pacientes com esquistossomose hepatoespl\u00eanica e hipertens\u00e3o portal, com hist\u00f3ria de hemorragia digestiva alta por ruptura de varizes esof\u00e1gicas, com idade m\u00e9dia de 37,9 anos. Estes pacientes n\u00e3o haviam sido submetidos a tratamento pr\u00e9vio e foram, eletivamente, tratados cirurgicamente com desconex\u00e3o \u00e1zigo-portal e esplenectomia. Durante a cirurgia, foi avaliada a press\u00e3o portal, no in\u00edcio e no final do procedimento, atrav\u00e9s da cateteriza\u00e7\u00e3o da veia porta por cateter de polietileno introduzido por veia jejunal. Todos os pacientes foram submetidos a endoscopia no pr\u00e9 e no p\u00f3s-operat\u00f3rio (em torno do 60\u00ba dia do p\u00f3s-operat\u00f3rio) para avaliar, segundo classifica\u00e7\u00e3o de Palmer, a varia\u00e7\u00e3o do calibre das varizes esofagianas ap\u00f3s a desconex\u00e3o \u00e1zigo-portal e esplenectomia. RESULTADOS: Todos os pacientes apresentaram queda da press\u00e3o portal, sendo a m\u00e9dia desta queda, ap\u00f3s a desconex\u00e3o \u00e1zigo-portal e esplenectomia, de 31,3%. Na avalia\u00e7\u00e3o p\u00f3s-operat\u00f3ria (endoscopia ap\u00f3s cerca de 60 dias) houve redu\u00e7\u00e3o significativa do calibre das varizes esofagianas quando comparadas ao pr\u00e9-operat\u00f3rio. CONCLUS\u00c3O: A desconex\u00e3o \u00e1zigo-portal e esplenectomia promoveram queda imediata na press\u00e3o portal, com conseq\u00fcente diminui\u00e7\u00e3o do calibre das varizes esof\u00e1gicas. Observou-se ainda que n\u00e3o \u00e9 insignificante o risco de mortalidade e complica\u00e7\u00f5es graves relacionados a essa t\u00e9cnica.<\/jats:p>","DOI":"10.1590\/s0004-28032004000300003","type":"journal-article","created":{"date-parts":[[2005,4,15]],"date-time":"2005-04-15T14:21:35Z","timestamp":1113574895000},"page":"150-154","source":"Crossref","is-referenced-by-count":5,"title":["Avalia\u00e7\u00e3o intra-operat\u00f3ria da press\u00e3o portal e resultados imediatos do tratamento cir\u00fargico da hipertens\u00e3o portal em pacientes esquistossom\u00f3ticos submetidos a desconex\u00e3o \u00e1zigo-portal e esplenectomia"],"prefix":"10.1590","volume":"41","author":[{"given":"Walter De Biase da","family":"Silva-Neto","sequence":"first","affiliation":[{"name":"Universidade Federal de Goi\u00e1s"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adalberto","family":"Cavarzan","sequence":"additional","affiliation":[{"name":"Universidade Federal de Goi\u00e1s"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo","family":"Herman","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","series-title":"Gastroenterologia cl\u00ednica","first-page":"983","volume-title":"Hipertens\u00e3o portal","author":"Abrantes W L","year":"1988"},{"key":"ref2","series-title":"Controv\u00e9rsias na cirurgia do aparelho digestivo","first-page":"283","volume-title":"As deriva\u00e7\u00f5es venosas no tratamento das varizes do es\u00f4fago","author":"Abrantes WL","year":"1991"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1440-1746.1986.tb00109.x","article-title":"Favourable outcome in sclerotherapy for bleeding oesophageal varices in schistosomiasis: results in 30 patients","volume":"1","author":"Al Karawi MA","year":"1986","journal-title":"J Gastroenterol 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