Endoscopic Sclerotherapy for Esophageal Varices, Its Practice and Prognosis Hiroaki Suzuki 1 , Yoshinori Inagaki 1 , Masayuki Kohyama 1 , Otomi Miho 1 , Yutaka Watanabe 1 , Fusahiro Nagao 1 1The Second Department of Surgery, The Jikei University, School of Medicine pp.489-495
Published Date 1985/5/25
DOI https://doi.org/10.11477/mf.1403109819
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 Since March 1979 we have actively practiced endoscopic sclerotherapy for esophageal varices.

 Materials and Methods: We have performed 434 endoscopic sclerotherapies on 138 patients with esophageal varices. There were 56 cases of acute bleeding and 82 cases with or without bleeding episodes. We selected 1% Aethoxysklerol (Kreussler Co.) as the safest sclerosant. It was injected araund the varices and then into the varices. The sclerotherapy was performed three times in a series with one week intervals and the follow-up was made every three months for observation or for repeat treatment if necessary.

 Results: 1) 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 or 87%. 2) We consider sclerotherapy not only to have a hemostatic effect but also to eradicate the varices in many cases. Among 88 cases followed-up for more than three months after the first sclerotherapy, esophageal varices diminished or were even eradicated in 78 cases or 89%. Rebleeding occurred only very occasionally (6%) in such successful cases. 3) Autopsy cases (5 cases) suggested to us a mechanism of hemostasis and prophylaxis of bleeding in cases of esophageal varices following endoscopic sclerotherapy. 4) Long term follow-up studies showed us that three-year cumulative survival rate was 87% in cases of Child A and B, and 12.8% in cases of Child C.

 Conclusion: We can say that the endoscopic sclerotherapy by para- and intra-variceal injection of 1% Aethoxysklerol which we are performing is an excellent non-surgical treatment for bleeding from esophageal varices and also an effective method to eradicate them.

Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.


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