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Surgical Endoscopy

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01-05-2021 | Portal Vein Thrombosis

Positive consequences of splenectomy for patients with schistosomiasis-induced variceal bleeding

Authors: Siyu Jiang, Xiaoquan Huang, Liyuan Ni, Ruiqi Xia, Kiyoko Nakayama, Shiyao Chen

Published in: Surgical Endoscopy | Issue 5/2021

Abstract

Background

Patients with hepatic schistosomiasis are at high risk of gastroesophageal variceal bleeding, which is highly torrential and life threatening. This study aimed to assess the effects of splenectomy on patients with schistosomiasis-induced variceal bleeding, especially those influences related to overall survival (OS) rate.

Methods

From January 2005 to December 2018, 112 patients with schistosomiasis-induced varices were enrolled. In that period, all the patients with hepatic schistosomiasis who received endoscopic treatment for primary and secondary prophylaxis of gastroesophageal variceal bleeding were found eligible. The patients were divided into splenectomized group (n = 44, 39.3%) and control group (n = 68, 60.7%).

Results

Multivariate regression analysis of OS showed that splenectomy, hepatic carcinoma, and times of endoscopic treatment were independent prognostic factors for OS. Kaplan–Meier analysis revealed that the 5-year OS rate was 82.7% in splenectomized group versus 53.2% in control group (P = 0.037). The rate of no recurrence of variceal bleeding during 5-year (56.8% vs. 47.7%, P = 0.449) indicated that there was no significant difference between the two groups. Patients who received splenectomy had increased risk of portal vein thrombosis (52.3% vs. 29.4%, P = 0.012) and decreased proportion of severe ascites (20.5% vs 50.0%, P = 0.002).

Conclusion

Splenectomy prior to endoscopic treatment provides a superior long-term survival for patients with schistosomiasis-induced variceal bleeding.

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Title: Positive consequences of splenectomy for patients with schistosomiasis-induced variceal bleeding
Authors: Siyu Jiang
Xiaoquan Huang
Liyuan Ni
Ruiqi Xia
Kiyoko Nakayama
Shiyao Chen
Publication date: 01-05-2021
Publisher: Springer US
Keywords: Portal Vein Thrombosis
Splenectomy
Splenectomy
Portal Vein Thrombosis
Schistosomiasis
Ascites
Hypertension
Portal Hypertension
Portal Hypertension
Published in: Surgical Endoscopy / Issue 5/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07648-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Positive consequences of splenectomy for patients with schistosomiasis-induced variceal bleeding

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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