Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varices

BACKGROUND: Endoscopic sclerotherapy is an absolute indication for treating esophageal varices. Re-bleeding is common during the treatment period, before all varices become eradicated. AIM: To compare two techniques of endoscopic esophageal varices eradication: sclerotherapy with absolute alcohol an...

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Authors: Ferrari, Angelo Paulo [UNIFESP], Paulo, Gustavo Andrade De [UNIFESP], Macedo, Claudia Maria Ferreira De, Araújo, Isabela [UNIFESP], Della Libera Jr, Ermelindo [UNIFESP]
Format: article
Status:Published version
Publication Date:2005
Country:Brasil
Institution:Universidade Federal de São Paulo (UNIFESP)
Repository:Repositório Institucional da UNIFESP
Language:English
OAI Identifier:oai:repositorio.unifesp.br:11600/2541
Online Access:http://dx.doi.org/10.1590/S0004-28032005000200002
http://repositorio.unifesp.br/handle/11600/2541
Access Level:Open access
Keyword:Esophageal and gastric varices
Ligation
Hypertension
Gastrointestinal hemorrhage
Varizes esofágica e gástricas
Ligadura
Hipertensão
Hemorragia gastrointestinal
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oai_identifier_str oai:repositorio.unifesp.br:11600/2541
network_acronym_str BR
network_name_str Brasil
repository_id_str
dc.title.none.fl_str_mv Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varices
Eficácia da injeção de álcool absoluto comparada com ligadura elástica na erradicação de varizes de esôfago
title Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varices
spellingShingle Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varices
Ferrari, Angelo Paulo [UNIFESP]
Esophageal and gastric varices
Ligation
Hypertension
Gastrointestinal hemorrhage
Varizes esofágica e gástricas
Ligadura
Hipertensão
Hemorragia gastrointestinal
title_short Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varices
title_full Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varices
title_fullStr Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varices
title_full_unstemmed Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varices
title_sort Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varices
dc.creator.none.fl_str_mv Ferrari, Angelo Paulo [UNIFESP]
Paulo, Gustavo Andrade De [UNIFESP]
Macedo, Claudia Maria Ferreira De
Araújo, Isabela [UNIFESP]
Della Libera Jr, Ermelindo [UNIFESP]
author Ferrari, Angelo Paulo [UNIFESP]
author_facet Ferrari, Angelo Paulo [UNIFESP]
Paulo, Gustavo Andrade De [UNIFESP]
Macedo, Claudia Maria Ferreira De
Araújo, Isabela [UNIFESP]
Della Libera Jr, Ermelindo [UNIFESP]
author_role author
author2 Paulo, Gustavo Andrade De [UNIFESP]
Macedo, Claudia Maria Ferreira De
Araújo, Isabela [UNIFESP]
Della Libera Jr, Ermelindo [UNIFESP]
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.subject.por.fl_str_mv Esophageal and gastric varices
Ligation
Hypertension
Gastrointestinal hemorrhage
Varizes esofágica e gástricas
Ligadura
Hipertensão
Hemorragia gastrointestinal
topic Esophageal and gastric varices
Ligation
Hypertension
Gastrointestinal hemorrhage
Varizes esofágica e gástricas
Ligadura
Hipertensão
Hemorragia gastrointestinal
description BACKGROUND: Endoscopic sclerotherapy is an absolute indication for treating esophageal varices. Re-bleeding is common during the treatment period, before all varices become eradicated. AIM: To compare two techniques of endoscopic esophageal varices eradication: sclerotherapy with absolute alcohol and banding ligation. PATIENTS AND METHOD: Forty-six patients with liver cirrhosis and esophageal varices were prospectively randomized into two treatment groups: endoscopic sclerotherapy with absolute alcohol and banding ligation. Patients were included if they had large varices with signs of high bleeding risk. Informed writing consent was obtained from every patient and the Ethics Committee of Federal University of São Paulo, SP, Brazil, approved the study. After eradication, all patients were followed up to 1 year to look for re-bleeding episodes and variceal recurrence. RESULTS: Both groups were similar except that male gender was more common in the sclerotherapy group. There was no statistical difference regarding variceal eradication (78.3% in sclerotherapy group vs 73.9% in the ligation group), recurrence (26.7% vs 42.9%, respectively) and death related to any cause (21.7% vs 13.9%). In the sclerotherapy group more sessions were need to obtain complete variceal eradication. In this group we did observe a high re-bleeding rate (34.8%) and more ulcers associated with retrosternal pain right after the procedure. There was no difference regarding overall morbidity and mortality. CONCLUSIONS: Banding ligation requires fewer sessions than sclerotherapy with absolute alcohol to eradicate esophageal varices. Both methods are equally efficient regarding variceal eradication and recurrence during a short follow-up period.
publishDate 2005
dc.date.none.fl_str_mv 2005-06-01
2015-06-14T13:31:36Z
2015-06-14T13:31:36Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S0004-28032005000200002
Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 42, n. 2, p. 72-76, 2005.
10.1590/S0004-28032005000200002
S0004-28032005000200002.pdf
0004-2803
S0004-28032005000200002
http://repositorio.unifesp.br/handle/11600/2541
dc.identifier.dark.fl_str_mv ark:/48912/0013000026j1s
url http://dx.doi.org/10.1590/S0004-28032005000200002
http://repositorio.unifesp.br/handle/11600/2541
identifier_str_mv Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 42, n. 2, p. 72-76, 2005.
10.1590/S0004-28032005000200002
S0004-28032005000200002.pdf
0004-2803
S0004-28032005000200002
ark:/48912/0013000026j1s
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Arquivos de Gastroenterologia
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 72-76
application/pdf
dc.publisher.none.fl_str_mv Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED
publisher.none.fl_str_mv Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
_version_ 1853670544812015616
spelling Efficacy of absolute alcohol injection compared with band ligation in the eradication of esophageal varicesEficácia da injeção de álcool absoluto comparada com ligadura elástica na erradicação de varizes de esôfagoEsophageal and gastric varicesLigationHypertensionGastrointestinal hemorrhageVarizes esofágica e gástricasLigaduraHipertensãoHemorragia gastrointestinalBACKGROUND: Endoscopic sclerotherapy is an absolute indication for treating esophageal varices. Re-bleeding is common during the treatment period, before all varices become eradicated. AIM: To compare two techniques of endoscopic esophageal varices eradication: sclerotherapy with absolute alcohol and banding ligation. PATIENTS AND METHOD: Forty-six patients with liver cirrhosis and esophageal varices were prospectively randomized into two treatment groups: endoscopic sclerotherapy with absolute alcohol and banding ligation. Patients were included if they had large varices with signs of high bleeding risk. Informed writing consent was obtained from every patient and the Ethics Committee of Federal University of São Paulo, SP, Brazil, approved the study. After eradication, all patients were followed up to 1 year to look for re-bleeding episodes and variceal recurrence. RESULTS: Both groups were similar except that male gender was more common in the sclerotherapy group. There was no statistical difference regarding variceal eradication (78.3% in sclerotherapy group vs 73.9% in the ligation group), recurrence (26.7% vs 42.9%, respectively) and death related to any cause (21.7% vs 13.9%). In the sclerotherapy group more sessions were need to obtain complete variceal eradication. In this group we did observe a high re-bleeding rate (34.8%) and more ulcers associated with retrosternal pain right after the procedure. There was no difference regarding overall morbidity and mortality. CONCLUSIONS: Banding ligation requires fewer sessions than sclerotherapy with absolute alcohol to eradicate esophageal varices. Both methods are equally efficient regarding variceal eradication and recurrence during a short follow-up period.RACIONAL: Escleroterapia endoscópica tem indicação absoluta no tratamento das varizes de esôfago. Ressangramento é comum durante o período de tratamento, antes que as varizes sejam erradicadas. OBJETIVO: Comparar duas técnicas de erradicação endoscópica de varizes de esôfago: escleroterapia com álcool absoluto e ligadura elástica. PACIENTES E MÉTODOS: Quarenta e seis pacientes com cirrose hepática e varizes de esôfago foram prospectivamente randomizados em dois grupos de tratamento: escleroterapia endoscópica com álcool absoluto e ligadura elástica. Os pacientes foram incluídos no estudo se tivessem varizes de grosso calibre com sinais de alto risco de sangramento. Consentimento informado por escrito foi obtido de cada paciente e o estudo foi aprovado pelo Comitê de Ética da instituição onde o estudo foi realizado. Após a erradicação, todos os pacientes foram seguidos durante 1 ano para avaliar a taxa de ressangramento e a recidiva das varizes. RESULTADOS: Ambos os grupos foram parecidos exceto no que se refere ao sexo masculino, mais comum no grupo da escleroterapia. Não houve diferença estatisticamente significante em relação a erradicação das varizes (78,3% no grupo da escleroterapia vs. 73,9% no grupo da ligadura), recidiva (26,7% vs. 42,9%, respectivamente) e mortalidade relacionada a qualquer causa (21,7% vs. 13,9%). No grupo da escleroterapia houve necessidade de maior número de sessões para obtenção da erradicação completa das varizes. Neste mesmo grupo observou-se alta taxa de ressangramento (34,8%) e presença de mais úlceras associadas com dor retroesternal logo após o procedimento. Não houve diferença na morbimortalidade global. CONCLUSÕES: O tratamento com ligadura elástica requer menos sessões do que a escleroterapia com álcool absoluto para erradicar as varizes de esôfago. Ambos os métodos são igualmente eficazes, a curto prazo, no que diz respeito à taxa de erradicação e recidiva das varizes.Federal University of São Paulo Division of GastroenterologyUNIFESP, Division of GastroenterologySciELOFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBEDUniversidade Federal de São Paulo (UNIFESP)2015-06-14T13:31:36Z2015-06-14T13:31:36Z2005-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion72-76application/pdfhttp://dx.doi.org/10.1590/S0004-28032005000200002Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 42, n. 2, p. 72-76, 2005.10.1590/S0004-28032005000200002S0004-28032005000200002.pdf0004-2803S0004-28032005000200002http://repositorio.unifesp.br/handle/11600/2541ark:/48912/0013000026j1sengArquivos de Gastroenterologiainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPFerrari, Angelo Paulo [UNIFESP]Paulo, Gustavo Andrade De [UNIFESP]Macedo, Claudia Maria Ferreira DeAraújo, Isabela [UNIFESP]Della Libera Jr, Ermelindo [UNIFESP]2024-08-04T13:41:44Zoai:repositorio.unifesp.br:11600/2541Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-04T13:41:44Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
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