Variceal recurrence after endoscopic sclerotherapy associated with the perforating veins in lower esophagus independently.
OBJECTIVE
The perforating veins as a lateral blood supply route for esophageal varices in lower esophagus are associated with the recurrence of esophageal varices after sclerotherapy, but not vessels at the esophagogastric junction as an ascending blood supply route. To date, however, frequency of association perforating veins alone with variceal recurrence has not been investigated. To clarify the influence of perforating veins alone on variceal recurrence after endoscopic injection sclerotherapy, we studied the prevalence of variceal recurrence in patients with perforating veins detected by endoscopic ultrasonography after treatment.


METHODS
Forty-two patients who underwent injection sclerotherapy and received endoscopic ultrasonography after treatment to evaluate the effect on the collaterals around the esophagus, were studied. Subjects were classified in four groups according to endosonographic findings as follows: group A: perforating veins (+) and vessels at esophagogastric junction (+), group B: perforating veins (+) and vessels at esophagogastric junction (-), group C: perforating veins (-) and vessels at esophagogastric junction (+), group D: perforating veins (-) and vessels at esophagogastric junction (-).


RESULTS
Variceal recurrence was observed in 60% (6/10) of patients in group A, 64.3% (9/14) of patients in group B, 33.3% (1/3) of patients in group C, 0% (0/15) of patients in group D, respectively. The prevalence of variceal recurrence was compared between the 4 groups. No significant difference between group A or C and B was noted, and there was a significant difference between group A or B and D.


CONCLUSIONS
These results suggested that perforating veins are highly associated with variceal recurrence after sclerotherapy even if perforating veins are independent.
Shibukawa
Goro
G
Department of Internal Medicine 2, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima City, Japan. goro-s@fmu.ac.jp
Irisawa
Atsushi
A
Saito
Ayako
A
Takahashi
Atsushi
A
Sato
Hiroshi
H
Takagi
Tadayuki
T
Yamamoto
Go
G
Hikichi
Takuto
T
Oyama
Hitoshi
H
Sato
Naoto
N
Sugino
Takashi
T
Suzuki
Toshimitsu
T
Obara
Katsutoshi
K
Sato
Yukio
Y
D004939:Esophageal Perforation / Q000150:complications; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D004945:Esophagoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015911:Sclerotherapy / Q000379:methods*