Randomized Clinical Trial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2800-2806
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2800
Effect of intravariceal sclerotherapy combined with esophageal mucosal sclerotherapy using small-volume sclerosant for cirrhotic patients with high variceal pressure
De-Run Kong, Jin-Guang Wang, Chen Chen, Fang-Fang Yu, Qiong Wu, Jian-Ming Xu
De-Run Kong, Jin-Guang Wang, Chen Chen, Fang-Fang Yu, Qiong Wu, Jian-Ming Xu, Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Author contributions: Kong DR and Wang JG contributed equally to this work; Wang JG was involved in acquisition, analysis and interpretation of data, and drafting of the manuscript; Chen C, Yu FF and Wu Q were involved in acquisition, analysis and interpretation of data; Kong DR and Xu JM were involved in study design, analysis and interpretation of data, critical revision of the manuscript and study supervision.
Supported by Educational and Health Department of Anhui Province, No. KJ2010A158, No. KJ2012Z189 and No. 2010B018; and National Natural Science Foundation of China, No. 81271736.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: De-Run Kong, MD, Professor, Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei 230022, Anhui Province, China. kongderun@ahmu.edu.cn
Telephone: +86-551-62922105 Fax: +86-551-65120742
Received: July 27, 2014
Peer-review started: July 27, 2014
First decision: September 27, 2014
Revised: October 28, 2014
Accepted: December 5, 2014
Article in press: December 8, 2014
Published online: March 7, 2015
Processing time: 225 Days and 4.8 Hours
Abstract

AIM: To explore the effect of intravariceal-mucosal sclerotherapy using small dose of sclerosant on the recurrence of esophageal varices.

METHODS: We randomly assigned 38 cirrhotic patients with previous variceal bleeding and high variceal pressure (> 15.2 mmHg) to receive endoscopic variceal ligation (EVL) and combined intravariceal and esophageal mucosal sclerotherapy (combined group) using small-volume sclerosant. The end-points of the study were rebleeding and recurrence of esophageal varices.

RESULTS: During a median follow-up period of 16 mo, varices recurred in 1 patient in the combined group as compared with 7 patients in the EVL group (P = 0.045). Rebleeding occurred in 3 patients in the EVL group as compared with 1 patient in the combined group (P = 0.687). No patient died in the two groups. No significant differences were observed between the two groups with respect to serious adverse events.

CONCLUSION: Intravariceal-mucosal sclerotherapy using small dose of sclerosant is more effective than EVL in decreasing the incidence of variceal recurrence for cirrhotic patients.

Keywords: Variceal bleeding; Endoscopic variceal ligation; Endoscopic injection sclerotherapy; Variceal pressure

Core tip: Intravariceal-mucosal sclerotherapy has more advantages compared to endoscopic variceal ligation alone in decreasing the incidence of variceal recurrence for cirrhotic patients with high variceal pressure.