Endoscopic ligation vs. sclerotherapy in adults with extrahepatic portal venous obstruction: a prospective randomized study

医学 硬化疗法 结扎 静脉曲张 食管静脉曲张 外科 瓦利克斯 随机对照试验 胃肠病学 前瞻性队列研究 并发症 门脉高压 肝硬化
作者
Showkat Ali Zargar,Gul Javid,Bashir Ahmad Khan,Omar Javid Shah,Ghulam Nabi Yattoo,Altaf Shah,Ghulam Mohammad Gulzar,Jaswinder Singh,N. A. Shah,Hakim Shafi
出处
期刊:Gastrointestinal Endoscopy [Elsevier BV]
卷期号:61 (1): 58-66 被引量:40
标识
DOI:10.1016/s0016-5107(04)02455-1
摘要

Background Endoscopic sclerotherapy is a well-established treatment for bleeding esophageal varices, although it has a substantial complication rate. A prospective randomized trial was conducted to determine whether endoscopic variceal ligation is safer and more effective than sclerotherapy in adults with bleeding esophageal varices because of extrahepatic portal venous obstruction. Methods Thirty-six patients underwent sclerotherapy and 37 had band ligation. Results Ligation and sclerotherapy were equally effective for achieving variceal eradication (94.6% vs. 91.7%, respectively; p = 0.67). However, ligation achieved eradication with fewer endoscopic sessions (3.7 [1.2] vs. 7.7 [3.3]; p < 0.0001) and within a shorter time interval (50.1 [17.7] days vs. 99 [54.8] days; p < 0.0001). In the ligation group, recurrent bleeding was less frequent (2.7% vs. 19.4%; p = 0.028; however, Bonferroni correction for multiple testing removes this significance) and the rate of major complications was lower (2.7% vs. 22.2%; p = 0.014). Total cost per patient was significantly higher in the sclerotherapy vs. the ligation group ($216.6 [71.8] vs. $182.6 [63.4]; p = 0.035). During the follow-up period after variceal eradication, no significant differences were found between the sclerotherapy and the ligation groups with respect to recurrent bleeding (3% vs. 2.9%; p = 1.0), esophageal variceal recurrence (9.1% vs. 11.4%; p = 1.0), and formation of new gastric varices (9.1% vs. 14.3%; p = 0.51). Conclusions Variceal band ligation is superior to sclerotherapy, because it is less costly and achieves variceal eradication more quickly, with lower relative frequencies of recurrent variceal bleeding and complications. Endoscopic sclerotherapy is a well-established treatment for bleeding esophageal varices, although it has a substantial complication rate. A prospective randomized trial was conducted to determine whether endoscopic variceal ligation is safer and more effective than sclerotherapy in adults with bleeding esophageal varices because of extrahepatic portal venous obstruction. Thirty-six patients underwent sclerotherapy and 37 had band ligation. Ligation and sclerotherapy were equally effective for achieving variceal eradication (94.6% vs. 91.7%, respectively; p = 0.67). However, ligation achieved eradication with fewer endoscopic sessions (3.7 [1.2] vs. 7.7 [3.3]; p < 0.0001) and within a shorter time interval (50.1 [17.7] days vs. 99 [54.8] days; p < 0.0001). In the ligation group, recurrent bleeding was less frequent (2.7% vs. 19.4%; p = 0.028; however, Bonferroni correction for multiple testing removes this significance) and the rate of major complications was lower (2.7% vs. 22.2%; p = 0.014). Total cost per patient was significantly higher in the sclerotherapy vs. the ligation group ($216.6 [71.8] vs. $182.6 [63.4]; p = 0.035). During the follow-up period after variceal eradication, no significant differences were found between the sclerotherapy and the ligation groups with respect to recurrent bleeding (3% vs. 2.9%; p = 1.0), esophageal variceal recurrence (9.1% vs. 11.4%; p = 1.0), and formation of new gastric varices (9.1% vs. 14.3%; p = 0.51). Variceal band ligation is superior to sclerotherapy, because it is less costly and achieves variceal eradication more quickly, with lower relative frequencies of recurrent variceal bleeding and complications.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
山谷发布了新的文献求助10
1秒前
感动黄豆发布了新的文献求助10
3秒前
5秒前
6秒前
6秒前
6秒前
8秒前
Owen应助晒太阳的加菲猫采纳,获得10
9秒前
anna发布了新的文献求助10
11秒前
11秒前
wu基督教发布了新的文献求助10
12秒前
13秒前
余南发布了新的文献求助10
14秒前
晒太阳的加菲猫完成签到,获得积分10
14秒前
笑点低诗桃完成签到,获得积分20
15秒前
泡泡脑瓜完成签到,获得积分10
15秒前
17秒前
liche发布了新的文献求助10
17秒前
18秒前
修管子发布了新的文献求助10
18秒前
19秒前
共享精神应助gx采纳,获得10
19秒前
高手完成签到,获得积分20
20秒前
无所谓的啦完成签到,获得积分10
20秒前
ylq关闭了ylq文献求助
21秒前
wu基督教完成签到,获得积分20
21秒前
22秒前
迷人的芹菜完成签到,获得积分10
22秒前
23秒前
Miracle发布了新的文献求助10
23秒前
高手发布了新的文献求助10
24秒前
24秒前
我啊完成签到 ,获得积分10
27秒前
slp发布了新的文献求助30
28秒前
28秒前
gx发布了新的文献求助10
30秒前
英姑应助笑点低诗桃采纳,获得10
32秒前
youwenjing11发布了新的文献求助10
32秒前
王铂然发布了新的文献求助10
35秒前
大模型应助GGBOND采纳,获得10
36秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989115
求助须知:如何正确求助?哪些是违规求助? 3531367
关于积分的说明 11253688
捐赠科研通 3269986
什么是DOI,文献DOI怎么找? 1804868
邀请新用户注册赠送积分活动 882078
科研通“疑难数据库(出版商)”最低求助积分说明 809105