Kong DR, Wang JG, Chen C, Yu FF, Wu Q, Xu JM. Effect of intravariceal sclerotherapy combined with esophageal mucosal sclerotherapy using small-volume sclerosant for cirrhotic patients with high variceal pressure. World J Gastroenterol 2015; 21(9): 2800-2806 [PMID: 25759552 DOI: 10.3748/wjg.v21.i9.2800]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Randomized Clinical Trial
Open-Access Policy of This Article
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/
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, 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
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.
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.
