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Retrospective analysis of endoscopic injection sclerotherapy for rectal varices compared with band ligation.

Sato T, Yamazaki K, Akaike J, Toyota J, Karino Y, Ohmura T - Clin Exp Gastroenterol (2010)

Bottom Line: The clinical outcomes, including complications, related to EIS or EBL retrospectively.In 25 of the 34 patients, EIS was performed weekly 2-5 times (mean, 2.7), and the total amount of sclerosant ranged from 3.2 to 12.0 mL (mean, 5.2 mL).All four patients with recurrence of bleeding were EBL cases, versus no EIS cases (P < 0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, Japan.

ABSTRACT

Background and aims: The study's aim was to evaluate the efficacy of endoscopic injection sclerotherapy (EIS) compared with endoscopic band ligation (EBL) in treating rectal varices.

Methods: Data from 34 consecutive patients who underwent endoscopic treatments for rectal varices were analyzed. The clinical outcomes, including complications, related to EIS or EBL retrospectively.

Results: In 25 of the 34 patients, EIS was performed weekly 2-5 times (mean, 2.7), and the total amount of sclerosant ranged from 3.2 to 12.0 mL (mean, 5.2 mL). After EIS, colonoscopy revealed shrinkage of the rectal varices in all 25 patients, with no complications reported. In 9 of the 34 patients, EBL was performed weekly 1-3 times (mean, 2.2), and bands were placed on the varices at 2-12 sites (mean, 8.0). After EBL, colonoscopy revealed ulcers and shrinkage of the rectal varices in all nine patients, eight of whom experienced no operative complications. The overall recurrence rate for rectal varices was 10 of 24 (41.7%), including 5 of 9 (55.6%) receiving EBL and 5 of 15 (33.3%) receiving EIS, over a 1-year follow-up period (n = 24). All four patients with recurrence of bleeding were EBL cases, versus no EIS cases (P < 0.05).

Conclusion: EIS appears superior to EBL with regard to effectiveness and complications after endoscopic treatment of rectal varices.

No MeSH data available.


Related in: MedlinePlus

A) Cb, F2, RC-positive rectal varices. B) Fluoroscopic observation with infusion of 5% EOI was performed to determine the extent of the varices. C) One week after, fluoroscopic observation with infusion of 5% EOI.Abbreviations: Cb, blue; EIS, endoscopic injection sclerotherapy; EOI, ethanolamine oleate with iopamidol; F2, enlarged and tortuous; RC, red color.
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f1-ceg-3-159: A) Cb, F2, RC-positive rectal varices. B) Fluoroscopic observation with infusion of 5% EOI was performed to determine the extent of the varices. C) One week after, fluoroscopic observation with infusion of 5% EOI.Abbreviations: Cb, blue; EIS, endoscopic injection sclerotherapy; EOI, ethanolamine oleate with iopamidol; F2, enlarged and tortuous; RC, red color.

Mentions: EIS was performed in 25 patients (14 of whom had a history of rectal bleeding, and the remaining 11 patients were determined to have a high risk of variceal bleeding based on endoscopic findings.7 In these EIS-treated patients, the underlying pathologies causing portal hypertension included LC in 13 patients, cirrhosis associated with HCC in six patients, IPH in three patients, PBC in two patients, and EHO in one patient. Cirrhosis was graded in 11 patients as Child–Pugh class A, in 13 patients as class B, and in one patient as class C (Table 1). EIS was performed weekly using 5% ethanolamine oleate with iopamidol (EOI), which was injected to rectal varices intermittently under fluoroscopy. Figure 1A shows Cb, F2, RC-positive rectal varices, and EIS was performed under fluoroscopy. The fluoroscopic observation with infusion of 5% EOI was performed to determine the extent of the varices (Figures 1B and 1C).


Retrospective analysis of endoscopic injection sclerotherapy for rectal varices compared with band ligation.

Sato T, Yamazaki K, Akaike J, Toyota J, Karino Y, Ohmura T - Clin Exp Gastroenterol (2010)

A) Cb, F2, RC-positive rectal varices. B) Fluoroscopic observation with infusion of 5% EOI was performed to determine the extent of the varices. C) One week after, fluoroscopic observation with infusion of 5% EOI.Abbreviations: Cb, blue; EIS, endoscopic injection sclerotherapy; EOI, ethanolamine oleate with iopamidol; F2, enlarged and tortuous; RC, red color.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108668&req=5

f1-ceg-3-159: A) Cb, F2, RC-positive rectal varices. B) Fluoroscopic observation with infusion of 5% EOI was performed to determine the extent of the varices. C) One week after, fluoroscopic observation with infusion of 5% EOI.Abbreviations: Cb, blue; EIS, endoscopic injection sclerotherapy; EOI, ethanolamine oleate with iopamidol; F2, enlarged and tortuous; RC, red color.
Mentions: EIS was performed in 25 patients (14 of whom had a history of rectal bleeding, and the remaining 11 patients were determined to have a high risk of variceal bleeding based on endoscopic findings.7 In these EIS-treated patients, the underlying pathologies causing portal hypertension included LC in 13 patients, cirrhosis associated with HCC in six patients, IPH in three patients, PBC in two patients, and EHO in one patient. Cirrhosis was graded in 11 patients as Child–Pugh class A, in 13 patients as class B, and in one patient as class C (Table 1). EIS was performed weekly using 5% ethanolamine oleate with iopamidol (EOI), which was injected to rectal varices intermittently under fluoroscopy. Figure 1A shows Cb, F2, RC-positive rectal varices, and EIS was performed under fluoroscopy. The fluoroscopic observation with infusion of 5% EOI was performed to determine the extent of the varices (Figures 1B and 1C).

Bottom Line: The clinical outcomes, including complications, related to EIS or EBL retrospectively.In 25 of the 34 patients, EIS was performed weekly 2-5 times (mean, 2.7), and the total amount of sclerosant ranged from 3.2 to 12.0 mL (mean, 5.2 mL).All four patients with recurrence of bleeding were EBL cases, versus no EIS cases (P < 0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, Japan.

ABSTRACT

Background and aims: The study's aim was to evaluate the efficacy of endoscopic injection sclerotherapy (EIS) compared with endoscopic band ligation (EBL) in treating rectal varices.

Methods: Data from 34 consecutive patients who underwent endoscopic treatments for rectal varices were analyzed. The clinical outcomes, including complications, related to EIS or EBL retrospectively.

Results: In 25 of the 34 patients, EIS was performed weekly 2-5 times (mean, 2.7), and the total amount of sclerosant ranged from 3.2 to 12.0 mL (mean, 5.2 mL). After EIS, colonoscopy revealed shrinkage of the rectal varices in all 25 patients, with no complications reported. In 9 of the 34 patients, EBL was performed weekly 1-3 times (mean, 2.2), and bands were placed on the varices at 2-12 sites (mean, 8.0). After EBL, colonoscopy revealed ulcers and shrinkage of the rectal varices in all nine patients, eight of whom experienced no operative complications. The overall recurrence rate for rectal varices was 10 of 24 (41.7%), including 5 of 9 (55.6%) receiving EBL and 5 of 15 (33.3%) receiving EIS, over a 1-year follow-up period (n = 24). All four patients with recurrence of bleeding were EBL cases, versus no EIS cases (P < 0.05).

Conclusion: EIS appears superior to EBL with regard to effectiveness and complications after endoscopic treatment of rectal varices.

No MeSH data available.


Related in: MedlinePlus