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Endoscopic sclerotherapy for esophageal varices its practice and prognosis

Endoscopic sclerotherapy for esophageal varices its practice and prognosis

Stomach & Intestine (Tokyo) 20(5): 489-495

Endoscopic sclerotherapies (434) were performed on 138 patients with esophageal varices. There were 56 cases of acute bleeding and 82 cases with or without bleeding episodes. Aethoxysklerol 1% was selected as the safest sclerosant. It was injected around and then into the varices. The sclerotherapy was performed 3 times in a series with 1 wk intervals and the follow-up was made every 3 mo. for observation or for repeat treatment if necessary. Among 56 cases of acute bleeding, emergency endoscopy showed active bleeding in 23 cases (flush bleeding in 9 cases and oozing bleeding in 14 cases). Bleeding was stopped by sclerotherapy in 20 cases (87%). Sclerotherapy had a hemostatic effect and also eradicated the varices in many cases. Among 88 cases followed up for > 3 mo. after the 1st sclerotherapy, esophageal varices diminished or were eradicated in 78 cases (89%). Rebleeding occurred only occasionally (6%). Autopsy cases (5 cases) suggested a mechanism of hemostasis and prophylaxis of bleeding in cases of esophageal varices following endoscopic sclerotherapy. Long-term follow-up studies showed that the 3 yr cumulative survival rate was 87% in some cases and 12.8% in other cases. Endoscopic sclerotherapy by para- and intra-variceal injection of 1% Aethoxysklerol was an excellent non-surgical treatment for bleeding from esophageal varices and also an effective method to eradicate them.

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Accession: 005359574

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