Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2800
Peer-review started: July 27, 2014
First decision: September 27, 2014
Revised: October 28, 2014
Accepted: December 5, 2014
Article in press: December 8, 2014
Published online: March 7, 2015
Processing time: 225 Days and 4.8 Hours
AIM: To explore the effect of intravariceal-mucosal sclerotherapy using small dose of sclerosant on the recurrence of esophageal varices.
METHODS: We randomly assigned 38 cirrhotic patients with previous variceal bleeding and high variceal pressure (> 15.2 mmHg) to receive endoscopic variceal ligation (EVL) and combined intravariceal and esophageal mucosal sclerotherapy (combined group) using small-volume sclerosant. The end-points of the study were rebleeding and recurrence of esophageal varices.
RESULTS: During a median follow-up period of 16 mo, varices recurred in 1 patient in the combined group as compared with 7 patients in the EVL group (P = 0.045). Rebleeding occurred in 3 patients in the EVL group as compared with 1 patient in the combined group (P = 0.687). No patient died in the two groups. No significant differences were observed between the two groups with respect to serious adverse events.
CONCLUSION: Intravariceal-mucosal sclerotherapy using small dose of sclerosant is more effective than EVL in decreasing the incidence of variceal recurrence for cirrhotic patients.
Core tip: Intravariceal-mucosal sclerotherapy has more advantages compared to endoscopic variceal ligation alone in decreasing the incidence of variceal recurrence for cirrhotic patients with high variceal pressure.