[Comparison of esophageal stenoses produced by endoscopic sclerotherapy versus variceal ligation].
BACKGROUND
Variceal ligation (VL) eradicates esophageal varices faster than endoscopic sclerotherapy (ES) with a lower rebleeding rate and fewer secondary effects. However, most studies have evaluated the short-term effects of these treatments and some late complications may be overlooked.


METHODS
To determine the incidence and the characteristics of stenosis, we included 253 cirrhotic patients treated endoscopically for variceal bleeding from 1988 to 2004 in our hospital. ES was carried out with ethanolamine 5% and polidocanol 1.5%. ES and VL were carried out every 15 days until varices were eradicated and then at 3-, 6- and 12-month intervals; if varices reappeared, the initial treatment was repeated. Stenosis was considered mild when esophageal size was more than 10 mm and severe when the endoscope could not be passed through the stricture.


RESULTS
We found stenosis in seven out of 105 (6.7%) ES-treated patients and in 10 out of 148 (6.7%) VL-treated patients. The clinical characteristics of the patients and the previous number of endoscopic sessions were similar in both groups. Four out of seven ES patients developed stenosis during the first eradication process (mean: 11 months, 1-60), but this early stenosis was observed in one out of 10 VL patients (mean: 20 months, 1-72). Stenosis was severe in three out of seven ES patients (43%) but in only two out of ten VL patients (20%) (NS).


CONCLUSIONS
The incidence of esophageal stenosis was similar after treatment of esophageal varices with ES and VL, although VL had a tendency to produce later stenosis.
de la Peña
Joaquín
J
Servicio de Aparato Digestivo. Hospital Universitario Marqués de Valdecilla. Santander. España. jpenagarcia@telefonica.net
Orive
Aitor
A
Cuadrado
Antonio
A
García Alles
Laura
L
Castro
Beatriz
B
Rivero
Montserrat
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004940:Esophageal Stenosis / Q000209:etiology*; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D015911:Sclerotherapy / Q000009:adverse effects