We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Endoscopic Injection Sclerotherapy for the Treatment of Recurrent Esophageal Varices after Esophageal Transection.
- Authors
Yoshida, Hiroshi; Onda, Masahiko; Tajiri, Takashi; Toba, Masahito; Umehara, Matsuomi; Mamada, Yasuhiro; Taniai, Nobuhiko; Yamashita, Kiyohiko
- Abstract
Background: We examined the hemodynamic changes associated with recurrent esophageal varices after esophageal transection (ET) and evaluated the effectiveness of endoscopic injection sclerotherapy (EIS) as the treatment for these varices. Methods: Nineteen patients with recurrent esophageal varices after ET were treated by EIS. Endoscopic varicealography during injection sclerotherapy, following oral blockage of flow by a balloon, identified three patterns: (i) type 1: common type, continuous filling by the feeder vessel of the varix; (ii) type 2: retrograde-disappearing type, confirmed hepatofugal flow; and (iii) type 3: immediate washout type, immediate washout of contrast medium. Results: Angiography revealed that the hepatofugal feeder vessel was the right gastric vein in all cases. Fourteen patients (73.7%) were classified as type 1, 4 patients (21.1%) as type 2, and 1 patient (5.3%) as type 3. Fewer treatment sessions were required in type 1 than in type 2 (P < 0.005). Recurrent varices were completely eradicated in all patients except the patient with type 3 disease. Cumulative re-recurrence rates at 5 and 10 years were similar for types 1 and 2 (28.6 and 71.4% vs 25 and 25%, respectively). The cumulative survival rates after EIS at 5 and 10 years were also similar for types 1 and 2 (77.1 and 66.1% vs 66.7 and 66.7%). Conclusion: Endoscopic injection sclerotherapy is an effective treatment for recurrent esophageal varices after ET, except in type 3 disease. Our classification based on endoscopic varicealography during injection sclerotherapy provides knowledge of blood flow within the varices that helps to inform the treatment strategy.
- Subjects
ESOPHAGEAL varices; ESOPHAGEAL surgery; SCLEROTHERAPY; THERAPEUTICS
- Publication
Digestive Endoscopy, 2002, Vol 14, Issue 3, p93
- ISSN
0915-5635
- Publication type
Article
- DOI
10.1046/j.1443-1661.2002.00185.x