TY - JOUR
T1 - Endoscopic ligation of esophageal varices compared with injection sclerotherapy
T2 - a prospective randomized trial
AU - Hashizume, Makoto
AU - Ohta, Masayuki
AU - Ueno, Kiichiro
AU - Tanoue, Kazuo
AU - Kitano, Seigo
AU - Sugimachi, Keizo
N1 - Funding Information:
Received June 1, 1992. For revision July 27, 1992. Accepted November 19,1992. From the Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan. This work was supported in part by a grant-in-aid for general scientific research, No. 02807122, from The Ministry of Education, Science and Culture, Japan.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1993
Y1 - 1993
N2 - Fifty cirrhotic patients with esophageal varices underwent endoscopic treatment in a prospective randomized trial carried out to compare variceal ligation with injection sclerotherapy, with respect to safety, efficacy, and complications in the initial session. Twenty-five patients each were treated using endoscopic variceal ligation or endoscopic injection sclerotherapy in the initial session and then only endoscopic injection sclerotherapy for all following sessions. Ligations numbered 4.1 at the initial session. The total number of sessions of endoscopic injection sclerotherapy was 4.0 ± 1.3 in the endoscopic injection sclerotherapy group compared with 3.6 ± 1.4 in the endoscopic variceal ligation group. The total volume of the sclerosant used by the end of all the sessions was 23.9 ± 10.3 ml in the endoscopic variceal ligation group and 39.0 ± 11.5 ml in the endoscopic injection sclerotherapy group (p < 0.0001). In all patients, complete eradication of the varices was achieved, and at 7 to 15 months follow-up no evidence of recurrence was seen. Adverse effects such as pyrexia, chest pain, and pleural effusion after the initial session were significantly lower in the endoscopic variceal ligation group (p < 0.05), and total bilirubin, serum creatinine, lactate dehydrogenase, and urinary β2-microglobulin were significantly increased and PaO2 decreased after endoscopic injection sclerotherapy (p < 0.05). This study shows that endoscopic variceal ligation significantly decreased the adverse effects associated with endoscopic injection sclerotherapy in the initial session, and it is recommended as an alternative to sclerotherapy.
AB - Fifty cirrhotic patients with esophageal varices underwent endoscopic treatment in a prospective randomized trial carried out to compare variceal ligation with injection sclerotherapy, with respect to safety, efficacy, and complications in the initial session. Twenty-five patients each were treated using endoscopic variceal ligation or endoscopic injection sclerotherapy in the initial session and then only endoscopic injection sclerotherapy for all following sessions. Ligations numbered 4.1 at the initial session. The total number of sessions of endoscopic injection sclerotherapy was 4.0 ± 1.3 in the endoscopic injection sclerotherapy group compared with 3.6 ± 1.4 in the endoscopic variceal ligation group. The total volume of the sclerosant used by the end of all the sessions was 23.9 ± 10.3 ml in the endoscopic variceal ligation group and 39.0 ± 11.5 ml in the endoscopic injection sclerotherapy group (p < 0.0001). In all patients, complete eradication of the varices was achieved, and at 7 to 15 months follow-up no evidence of recurrence was seen. Adverse effects such as pyrexia, chest pain, and pleural effusion after the initial session were significantly lower in the endoscopic variceal ligation group (p < 0.05), and total bilirubin, serum creatinine, lactate dehydrogenase, and urinary β2-microglobulin were significantly increased and PaO2 decreased after endoscopic injection sclerotherapy (p < 0.05). This study shows that endoscopic variceal ligation significantly decreased the adverse effects associated with endoscopic injection sclerotherapy in the initial session, and it is recommended as an alternative to sclerotherapy.
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U2 - 10.1016/S0016-5107(93)70050-4
DO - 10.1016/S0016-5107(93)70050-4
M3 - Article
C2 - 8495830
AN - SCOPUS:0027256545
SN - 0016-5107
VL - 39
SP - 123
EP - 126
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 2
ER -