Treatment of esophageal varices: a randomized controlled trial comparing endoscopic sclerotherapy and EUS-guided sclerotherapy of esophageal collateral veins

Treatment of esophageal varices: a randomized controlled trial comparing endoscopic sclerotherapy and EUS-guided sclerotherapy of esophageal collateral veins

Autor Paulo, G. A. de Google Scholar
Ardengh, J. C. Google Scholar
Nakao, F. S. Google Scholar
Ferrari, A. P. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Background: Endoscopic sclerotherapy (ES) and band ligation are standard treatments for esophageal varices. Unfortunately, recurrence is common and seems to be related to esophageal collateral vessels, easily identified by EUS. Eradication of these vessels might lead to a more durable therapeutic effect.Objective: To compare ES with EUS-guided sclerotherapy of collateral vessels (EUS-ES) Design: Randomized controlled trial. Setting: Endoscopy Unit, Division of Gastroenterology. Universidade Federal de São Paulo, São Paulo, Brazil. Patients and interventions: Fifty cirrhotic patients with esophageal varices were randomized into 2 groups: ES (n = 25) and EUS-ES (n = 25). EUS-ES was targeted at collateral veins. Patients were followed-up for at least 6 months after eradication.Main Outcome Measurements: Efficacy in eradication, complications, and recurrence of varices.Results: Varices were eradicated in 48 patients who adhered to the study protocol. the mean (SD) number of sessions until eradication was 4.3 (1-5) for the ES group and 4.1 (1.2) for the EUS-ES group. in ES group, 4 patients had mild bleeding. in EUS-ES group, 4 patients had pain. the mean (SD) length of the follow-up period was 22.6 (6.9) months for the ES group and 24.9 (8.1) months for the EUS-ES group. Recurrence was seen in 4 patients after ES and in 2 after EUS-ES (P =.32). the presence of collateral vessels was associated with recurrence (P =.003).Conclusion: EUS-ES is as safe and effective as ES in variceal eradication. Recurrence tends to be less frequent and occurs later. Persistence of esophageal collateral vessels after sclerotherapy is a risk factor for recurrence.
Idioma Inglês
Data de publicação 2006-03-01
Publicado em Gastrointestinal Endoscopy. St Louis: Mosby, Inc, v. 63, n. 3, p. 396-402, 2006.
ISSN 0016-5107 (Sherpa/Romeo, fator de impacto)
Publicador Mosby, Inc
Extensão 396-402
Fonte http://dx.doi.org/10.1016/j.gie.2005.10.039
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000235781100007
Endereço permanente http://repositorio.unifesp.br/handle/11600/28771

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