Premium
Secure intravariceal sclerotherapy with red dichromatic imaging decreases the recurrence rate of esophageal varices: A propensity score matching analysis
Author(s) -
Furuichi Yoshihiro,
Abe Masakazu,
Kasai Yoshitaka,
Takeuchi Hirohito,
Yoshimasu Yuu,
Itoi Takao
Publication year - 2021
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.894
Subject(s) - propensity score matching , esophageal varices , medicine , sclerotherapy , gastroenterology , adverse effect , proportional hazards model , incidence (geometry) , varices , surgery , portal hypertension , mathematics , cirrhosis , geometry
Background Red dichromatic imaging (RDI) is next‐generation image‐enhanced endoscopy technique released in July 2020. We previously reported that RDI can predict esophageal varices (EV) depth and decrease their recurrence rate by accurate intravariceal injections during endoscopic injection sclerotherapy (EIS) using unreleased prototype RDI endoscope. In this study, we analyzed whether RDI improves the overall survival (OS) rate and whether it is more accurate independent predictor of EV recurrence than white light imaging (WLI), using propensity score matching. Methods A total of 179 patients were enrolled. Patients were matched for age, platelet count, liver function, EV size, luminal diameter, and EV depth using propensity score matching, and 78 patients (RDI, 39; WLI, 39) were finally matched. Primary endpoints were OS and recurrence rates. Secondary endpoints were success rate of intravariceal injection, operating time, incidence of adverse events (AEs), and predictors associated with OS and recurrence rates. Results There was no difference in OS ( P = .193), but the cumulative recurrence rate in the RDI group was significantly lower than in the WLI group ( P = .002). Success rates of intrainjection, operating time, and incidence of AEs were better in the RDI group ( p = 0.035, .026, and .0019, respectively). Independent predictors associated with recurrence rate by Cox proportional regression were RDI function and luminal diameter ( P < .001 and .017, respectively). Conclusion RDI did not improve OS but decreased the recurrence rate. Independent predictors of recurrence rate were RDI and luminal diameter, resulting from secure intravariceal injections in EIS.