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Endoscopic neodymium yttrium aluminum garnet laser therapy for active esophageal variceal bleeding a randomized controlled study



Endoscopic neodymium yttrium aluminum garnet laser therapy for active esophageal variceal bleeding a randomized controlled study



Gastrointestinal Endoscopy 31(1): 4-9



A randomized controlled double-blind study was undertaken to assess the efficacy and safety of endoscopic neodymium:yttrium aluminum garnet (Nd:YAG) laser therapy for active esophageal variceal bleeding. Ten patients were randomized to the laser treatment group and 10 to a control group that received sham endoscopy and standard medical therapy. Initial hemostasis was achieved in 7 laser-treated patients and in 0 controls receiving sham treatment (P < 0.002). Four of the 7 who were initially controlled with laser therapy had rebleeding 12-48 h later; 3 of 10 laser patients had lasting hemostasis. The mean blood transfusion requirements were similar in both groups (laser = 7.3 U; control = 7.8 U). Six of the 10 laser-treated patients were discharged from the hospital and 4 died. There were 7 hospital deaths in the control group and 3 patients were discharged (P = 0.22). In 2 patients in the treatment group, laser therapy increased bleeding. There were no perforations.

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Accession: 005359402

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