The value of the endoscopic therapies in the treatment of rectal varices: a retrospective comparison between injection sclerotherapy and band ligation.
This study consisted of 15 patients who had undergone endoscopic injection sclerotherapy (EIS) or endoscopic variceal ligation (EVL) for rectal varices. Ten of fifteen patients had histories of anal bleeding, and colonoscopy revealed signs of the risk of variceal rupture in the other five patients. EIS was perfomed in six of the fifteen patients, and the other nine patients underwent EVL. EIS was performed weekly from 2 to 4 times (mean, 3.0), and the total amount of sclerosant ranged from 3.2 to 5.8ml (mean, 4.9ml). After EIS, colonoscopy revealed shrinkage of the rectal varices in all six patients with no complications. EVL was performed weekly from 1 to 3 times (mean, 2.2), and bands were placed on the varices at 2-12 sites (mean, 8.0). After EVL, colonoscopy revealed both ulcers and shrinkage of the varices in the rectum in all nine patients. Eight of the nine experienced no operative complications. However, in the other case, colonoscopy revealed bleeding from ulcers after EVL. The average follow-up period after EIS or EVL was 30 months. The overall non-recurrence rate of rectal varices was 11 of 15 (73.3%); this includes five of the six patients (83.3%) receiving EIS and six of the nine who received EVL (66.7%). The non-recurrence rate was no difference between EIS group and EVL group statistically (P=0.57) by reason of small number of cases. In conclusion, EIS is some superior to EVL with regard to long-term effectiveness, complications on rectal varices.
Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, Japan.
Takahiro
T
Sato
Katsu
K
Yamazaki
Jouji
J
Toyota
Yoshiyasu
Y
Karino
Takumi
T
Ohmura
Toshihiro
T
Suga