| Description: |
Introduction: Endoscopic treatment for esophageal varices has been used as the main intervention in patients with portal hypertension secondary to schistosomiasis, but with significant rates of recurrence of esophageal varices and rebleeding. The long-term results of exclusive endoscopic treatment are poorly studied as the relationship of the splenic dimensions in this context. Objective: To identify, through ultrasonography, cut-off values for splenic index and longitudinal (craniocaudal) dimension of the spleen as predictors of rebleeding and varicose recurrence in late follow up of nonoperated schistosomiasis patients, after endoscopic eradication of esophageal varices. Methodology: Retrospective observational study by analysis of medical records of patients diagnosed with hepatosplenic schistosomiasis. The ROC Curve was used to determine the best cutoff point for the mean splenic index as predictor of recurrence and bleeding. Statistical analysis was performed in the SAS 9.1 program, and a significance level of 5% was adopted. Results: A follow-up of 54 patients was analyzed during the period from 2002 to 2018. Mean follow-up time was 8 years regarding abdomen doppler ultrasonography, endoscopic exams and laboratory tests. The splenic index proved to be a sensitive test in values above 144 as a predictor of rebleeding. (VP-85%, AUC = 0.70, p = 0.044). In the analysis of the longitudinal dimension, the value above 20 cm showed a very specific and statistically significant test for recurrence of varices (VP + of 100%, AUC 0.71, p = 0.047) and a value above 19 cm presented as a very sensitive and statistically significant test for rebleeding (VP-100%, AUC 0.76, p = 0.008). Conclusion: Splenic index and craniocaudal dimension analysis, obtained by ultrasonography exam, can predict recurrence of varicose veins and rebleeding after exclusive endoscopic eradication, contributing to the therapeutic planning of schistosomiasis patients with portal hypertension. ; Introdução: O tratamento endoscópico das varizes de ... |