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Endoscopic injection sclerotherapy for 1,000 patients with esophageal varices: A nine‐year prospective study
Author(s) -
Hashizume Makoto,
Kitano Seigo,
Koyanagi Nobuhiro,
Tanoue Kazuo,
Ohta Masayuki,
Wada Hiroya,
Yamaga Hirohiko,
Higashi Hidefumi,
Iso Yasunori,
Iwanaga Tetsuya,
Sugimachi Keizo
Publication year - 1992
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840150114
Subject(s) - medicine , esophageal varices , sclerotherapy , varices , hepatology , varix , endoscopy , gastroenterology , concomitant , esophageal disease , esophagus , prospective cohort study , portal hypertension , surgery , esophageal ulcer , cirrhosis
We report here the results of endoscopic injection sclerotherapy performed in 1,000 consecutively treated Japanese patients with esophageal varices. This prospective study covered the period from 1982 to 1990. Variceal bleeding was controlled in 215 (97.7%) of 220 patients. Esophageal varices were completely eradicated in 778 patients (77.8%); the mean number of sessions was 4.2. In only 3 of the 778 patients did esophageal varices of the same size recur. Small, dilated, venous vessels that required additional sclerotherapy in follow‐up endoscopy at 3‐mo intervals appeared in 171 (22.2%) of 778 patients. The cumulative nonbleeding rate at 5 yr was 94.5% in patients in whom the varices had been eradicated. Deaths caused by upper gastrointestinal bleeding accounted for 2.6% of cases, whereas the rates of liver failure and hepatoma were 4.6% and 47.3%, respectively. The 5‐yr cumulative survival rate was 54.1% in patients without concomitant hepatoma; it was 12.0% in patients with hepatomas. Multivariate analysis showed that hepatoma, Child classification, indication (acute, elective or prophylactic) and eradication were independent factors that significantly influenced survival time. This study clearly shows that close follow‐up with endoscopy and complete eradication lead to significant reduction in bleeding from esophageal varices and reduction of mortality related to this bleeding. (H EPATOLOGY 1992;15:69–75).