title: Secondary prophylaxis of esophageal variceal treatment: Endoscopic sclerotherapy, band ligation and combined therapy--long-term results.
abstract: OBJECTIVE
  To evaluate the long-term results of endoscopic sclerotherapy and endoscopic band ligation in secondary prophylaxis on variceal eradication and to evaluate the effectiveness of endoscopic sclerotherapy and endoscopic band ligation combination in resistant cases.
  
  
  METHODS
  The results of the patients who underwent endoscopic sclerotherapy (n=47 31M/16F, 49.9+/-16.1 years) and endoscopic band ligation (n=72 56M/16F, 46.6+/-14.1 years) were compared. The results of patients whose varices could not be eradicated who were treated with endoscopic band ligation and combined endoscopic sclerotherapy (combined group, n=62 49M/13F, 48.8+/-12.7 years) are also given. Patients were evaluated for portal hypertension etiology, Child score, fundal varices-portal hypertensive gastropathy presence according to first and last endoscopic findings, varices eradication, rebleeding, recurrence and complication rates.
  
  
  RESULTS
  181 patients were followed for 35.2+/- 25.6 (6-123) months. Varices eradication and recurrence rates were 93.6% and 44.7% for endoscopic sclerotherapy, and 90.3% and 47.2% for endoscopic band ligation (p>0.05). The number of sessions for eradication were 6.6+/-4.0 and 2.5+/-1.6 for endoscopic sclerotherapy and endoscopic band ligation groups, respectively (p<0.05). Rebleeding rates were 16.3% for endoscopic sclerotherapy and 6.1% for endoscopic band ligation (p>0.05). In the combined group, although the rebleeding rate was 34.4%, which was as expected significantly higher than that of endoscopic sclerotherapy and endoscopic band ligation, variceal eradication and the recurrence rates were 82.3% and 50.0%, similar to endoscopic sclerotherapy and endoscopic band ligation, and the number of sessions for eradication was 6.8+/-3.5.
  
  
  CONCLUSIONS
  Endoscopic band ligation is the most suitable method for varices eradication, but there is a group of patients resistant to endoscopic band ligation. In this patient group, the addition of endoscopic sclerotherapy to endoscopic band ligation was a suitable and effective technique in order to achieve variceal eradication.
authors.affiliation: Gastroenterology Clinic, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. sedefozdal@hotmail.com
authors.forename: Sedef
authors.initials: S
authors.lastname: Kuran
authors.forename: Dilek
authors.initials: D
authors.lastname: Oğuz
authors.forename: Erkan
authors.initials: E
authors.lastname: Parlak
authors.forename: Mehmet
authors.initials: M
authors.lastname: Asil
authors.forename: Bahattin
authors.initials: B
authors.lastname: Ciçek
authors.forename: Mesut
authors.initials: M
authors.lastname: Kiliç
authors.forename: Selçuk
authors.initials: S
authors.lastname: Dişibeyaz
authors.forename: Burhan
authors.initials: B
authors.lastname: Sahin
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult