{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T16:08:43Z","timestamp":1649002123218},"reference-count":18,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:p>RACIONAL: A ligadura com bandas el\u00e1sticas tem se tornado o tratamento de escolha das varizes esof\u00e1gicas, devido aos bons resultados e as menores taxas de complica\u00e7\u00f5es quando comparada \u00e0 esclerose. Seu mecanismo de a\u00e7\u00e3o baseia-se na compress\u00e3o mec\u00e2nica do cord\u00e3o varicoso com interrup\u00e7\u00e3o do fluxo sang\u00fc\u00edneo e posterior trombose. Tendo como base este mecanismo de a\u00e7\u00e3o, desenvolveu-se um m\u00e9todo alternativo no qual o cord\u00e3o varicoso \u00e9 ligado com uma al\u00e7a confeccionada com fio de poliamida OBJETIVO: Avaliar a viabilidade do tratamento das varizes esof\u00e1gicas por m\u00e9todo de ligaduras com al\u00e7as pr\u00e9-atadas confeccionadas com fio de poliamida, analisando as altera\u00e7\u00f5es locais, a seguran\u00e7a, a efic\u00e1cia e as complica\u00e7\u00f5es deste m\u00e9todo de tratamento. CASU\u00cdSTICA E M\u00c9TODOS: Entre mar\u00e7o de 1998 e maio de 2000, 58 pacientes com varizes de es\u00f4fago foram tratados com ligaduras com al\u00e7as pr\u00e9-atadas, confeccionadas com fio de poliamida (26 esquistossom\u00f3ticos, 11 com cirrose alco\u00f3lica, 9 com hepatite C, 5 com hepatite B, 4 de causa n\u00e3o esclarecida, 2 com hepatite B e C e 1 com s\u00edndrome de Budd-Chiari; 42 pacientes eram do sexo masculino e 16 do sexo feminino, com m\u00e9dia de idade de 47,67 \u00b1 13,12 anos). Confeccionou-se artesanalmente um canal acess\u00f3rio que acoplado \u00e0 extremidade do endosc\u00f3pio, permitia que al\u00e7as pr\u00e9-atadas feitas com fio de poliamida fossem conduzidas ao es\u00f4fago com aux\u00edlio de tubo met\u00e1lico flex\u00edvel para se proceder \u00e0s ligaduras das varizes esof\u00e1gicas. No total, 506 ligaduras foram realizadas, distribu\u00eddas por 223 sess\u00f5es (m\u00e9dia 2,26 \u00b1 1,08 ligaduras por sess\u00e3o). As sess\u00f5es foram realizadas com intervalos de 15 dias at\u00e9 a completa erradica\u00e7\u00e3o das varizes esof\u00e1gicas. A ecoendoscopia foi utilizada como m\u00e9todo complementar para avaliar a erradica\u00e7\u00e3o das varizes em 10 doentes RESULTADOS: O procedimento foi realizado com sucesso em todos os pacientes. A completa erradica\u00e7\u00e3o das varizes foi obtida em 47 (81,03%) doentes. Em 37 (63,79%) as ligaduras resultaram em pseudop\u00f3lipos. N\u00e3o foram identificados complica\u00e7\u00f5es sist\u00eamicas ou \u00f3bitos. A ecoendoscopia mostrou trombose nos pseudop\u00f3lipos formados. No per\u00edodo de seguimento que variou de 4 a 32 meses, observou-se recidiva das varizes em 9 (15,51%) pacientes, tratados com \u00eaxito por nova ligadura com fio de poliamida em 5 pacientes e esclerose endosc\u00f3pica em 4. O custo m\u00e9dio de cada ligadura foi estimado em R$ 3,60 CONCLUS\u00d5ES: O tratamento endosc\u00f3pico, utilizando ligadura com fio de poliamida, revelou ser m\u00e9todo seguro, eficaz, de simples realiza\u00e7\u00e3o e de baixo custo, no tratamento das varizes esof\u00e1gicas. Esse m\u00e9todo demonstrou tamb\u00e9m um novo aspecto que \u00e9 a oblitera\u00e7\u00e3o das varizes esof\u00e1gicas, pelos pseudop\u00f3lipos, sem necrose.<\/jats:p>","DOI":"10.1590\/s0004-28032006000400016","type":"journal-article","created":{"date-parts":[[2007,4,11]],"date-time":"2007-04-11T13:29:42Z","timestamp":1176298182000},"page":"328-333","source":"Crossref","is-referenced-by-count":0,"title":["Tratamento endosc\u00f3pico das varizes esof\u00e1gicas utilizando al\u00e7as pr\u00e9-atadas confeccionadas com fio de poliamida"],"prefix":"10.1590","volume":"43","author":[{"given":"Francisco Susumu Corr\u00eaa","family":"Koyama","sequence":"first","affiliation":[{"name":"Hospital S\u00edrio Liban\u00eas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoshi","family":"Hashiba","sequence":"additional","affiliation":[{"name":"Hospital S\u00edrio Liban\u00eas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sansom 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