Absolute ethanol and 5% ethanolamine oleate are comparable for sclerotherapy of esophageal varices.
BACKGROUND
Endoscopic sclerotherapy is widely accepted as an effective treatment for the eradication of esophageal varices in patients with portal hypertension and a history of upper gastrointestinal bleeding. The objective of this study was to assess the effectiveness and safety of absolute ethanol as an alternative sclerosing agent to the commonly used 5% ethanolamine oleate.


METHODS
One hundred fifty-seven patients with portal hypertension and a history of variceal bleeding were randomly assigned to sclerotherapy with absolute ethanol (n = 66) or 5% ethanolamine oleate (n = 91) between January 1992 and July 1994. Once eradication was achieved, these patients were prospectively followed until September 1998.


RESULTS
Sclerotherapy with both sclerosants resulted in similar eradication rates (approximately 90%), with comparable numbers of sessions required for eradication (5.4 and 5.9 sessions for absolute ethanol and 5% ethanolamine oleate, respectively). Similar complication and recurrent bleeding rates were observed among both groups.


CONCLUSIONS
Sclerotherapy with absolute ethanol is as effective as with 5% ethanolamine oleate in preventing further bleeding in patients with portal hypertension.
Meirelles-Santos
J O
JO
Endoscopy Unit-Gastrocentro, Department of Surgery, Medical Genetics and Discipline of Clinical Gastroenterology, UNICAMP, Campinas, Brazil.
Carvalho
A F
AF
Callejas-Neto
F
F
Magna
L A
LA
Yamanaka
A
A
Zeitune
J M
JM
Brandalise
N A
NA
Ferraz
J G
JG
D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D000431:Ethanol / Q000008:administration & dosage*; D019856:Ethanolamine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019233:Retreatment; D015911:Sclerotherapy
D000431:Ethanol; D019856:Ethanolamine