Endoscopic treatment of esophageal varices in advanced liver disease patients: band ligation versus cyanoacrylate injection

dc.contributor.authorMartins Santos, Marcus Melo [UNIFESP]
dc.contributor.authorLenz Tolentino, Luciano Henrique [UNIFESP]
dc.contributor.authorRodrigues, Rodrigo Azevedo [UNIFESP]
dc.contributor.authorNakao, Frank Shigueo [UNIFESP]
dc.contributor.authorSilveira Rohr, Maria Rachel da [UNIFESP]
dc.contributor.authorPaulo, Gustavo Andrade de [UNIFESP]
dc.contributor.authorKondo, Mario [UNIFESP]
dc.contributor.authorFerrari, Angelo Paulo [UNIFESP]
dc.contributor.authorDella Libera, Ermelindo [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:06:01Z
dc.date.available2016-01-24T14:06:01Z
dc.date.issued2011-01-01
dc.description.abstractBackground the results of variceal band ligation (VBL) in patients with advanced liver disease are unknown. Cyanoacrylate injection (CI) might have a better outcome than VBL in the treatment of esophageal varices (EV) in these patients.Aim To compare VBL and CI in the treatment of EV in patients with advanced liver disease.Patients and methods Thirty-eight patients with medium or large EV and Child-Pugh index of at least eight were randomized into two groups: VBL (n = 20) and CI (n = 18). the patients were followed-up for at least 6 months after the end of treatment. Main outcomes were eradication, bleeding, mortality, complication, and recurrence rates.Results Variceal eradication rates were similar in the VBL and CI groups (90 vs. 72%, P = 0.39). Mean number of sessions until eradication was 3.17 and 3, respectively. Bleeding episodes until eradication were equally observed in both groups (P = 0.17). Mortality (55 vs. 56%, P = 0.52) and major complication rates (5 and 17%, P = 0.32) were similar. Chest pain with dysphagia was more frequent in the CI group (55.6 vs. 10%, P = 0.004). A higher risk of variceal recurrence was observed in the CI group (33 vs. 57%, P = 0.04).Conclusion No significant differences between the VBL and CI groups were observed in the treatment of EV in patients with advanced liver disease regarding mortality, variceal eradication, and major complications rates. However, minor complications and variceal recurrence were significantly more common in the CI group. in addition, there was a clear trend toward more bleeding episodes in patients included in the CI group. Eur J Gastroenterol Hepatol 23:60-65 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.en
dc.description.affiliationUniversidade Federal de São Paulo, Div Gastroenterol, BR-04039002 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Div Gastroenterol, BR-04039002 São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent60-65
dc.identifierhttp://dx.doi.org/10.1097/MEG.0b013e3283415986
dc.identifier.citationEuropean Journal of Gastroenterology & Hepatology. Philadelphia: Lippincott Williams & Wilkins, v. 23, n. 1, p. 60-65, 2011.
dc.identifier.doi10.1097/MEG.0b013e3283415986
dc.identifier.issn0954-691X
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/33316
dc.identifier.wosWOS:000285085400009
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofEuropean Journal of Gastroenterology & Hepatology
dc.rightsAcesso restrito
dc.subjectband ligationen
dc.subjectcyanoacrylateen
dc.subjectesophageal varicesen
dc.subjectliver cirrhosisen
dc.subjectportal hypertensionen
dc.titleEndoscopic treatment of esophageal varices in advanced liver disease patients: band ligation versus cyanoacrylate injectionen
dc.typeArtigo
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