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Prophylactic sclerotherapy for esophageal varices: long-term results of a prospective study.
Endoscopy. 1994 Nov; 26(9):729-33.E

Abstract

Controlled trials of endoscopic sclerotherapy for the prevention of the first variceal hemorrhage have given controversial results. We continued a previously reported study and randomly assigned 141 patients with esophageal varices and no prior gastrointestinal bleeding to either prophylactic sclerotherapy (n = 70) or no treatment (n = 71). Sclerotherapy was performed until complete eradication of the varices was achieved; recurrent varices were treated with repeat sclerotherapy. The groups were well balanced in terms of demographic and clinical characteristics. Patients in both groups who bled from varices received sclerotherapy whenever possible. During a median follow-up of 56 months, variceal bleeding occurred in 7% in sclerotherapy patients and 44% of control patients (p < 0.01). In the sclerotherapy group 59% died, and in the control group 51% (n.s.). In both groups, the mortality rate increased with the severity of liver function impairment. Sclerotherapy was not found to improve survival in patients, irrespective of the etiology of cirrhosis (alcoholic or nonalcoholic) or variceal size (low-grade or high-grade). We conclude that sclerotherapy is a suitable method to reduce the occurrence of the first variceal hemorrhage, but it does not appear to have an effect on survival.

Authors+Show Affiliations

Foehrenkamp Hospital, Federal Institute of Salaried Employees' Insurance, Moelln, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

7712966

Citation

Koch, H, et al. "Prophylactic Sclerotherapy for Esophageal Varices: Long-term Results of a Prospective Study." Endoscopy, vol. 26, no. 9, 1994, pp. 729-33.
Koch H, Binmoeller KF, Grimm H, et al. Prophylactic sclerotherapy for esophageal varices: long-term results of a prospective study. Endoscopy. 1994;26(9):729-33.
Koch, H., Binmoeller, K. F., Grimm, H., Soehendra, N., Henning, H., & Oehler, G. (1994). Prophylactic sclerotherapy for esophageal varices: long-term results of a prospective study. Endoscopy, 26(9), 729-33.
Koch H, et al. Prophylactic Sclerotherapy for Esophageal Varices: Long-term Results of a Prospective Study. Endoscopy. 1994;26(9):729-33. PubMed PMID: 7712966.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic sclerotherapy for esophageal varices: long-term results of a prospective study. AU - Koch,H, AU - Binmoeller,K F, AU - Grimm,H, AU - Soehendra,N, AU - Henning,H, AU - Oehler,G, PY - 1994/11/1/pubmed PY - 1994/11/1/medline PY - 1994/11/1/entrez SP - 729 EP - 33 JF - Endoscopy JO - Endoscopy VL - 26 IS - 9 N2 - Controlled trials of endoscopic sclerotherapy for the prevention of the first variceal hemorrhage have given controversial results. We continued a previously reported study and randomly assigned 141 patients with esophageal varices and no prior gastrointestinal bleeding to either prophylactic sclerotherapy (n = 70) or no treatment (n = 71). Sclerotherapy was performed until complete eradication of the varices was achieved; recurrent varices were treated with repeat sclerotherapy. The groups were well balanced in terms of demographic and clinical characteristics. Patients in both groups who bled from varices received sclerotherapy whenever possible. During a median follow-up of 56 months, variceal bleeding occurred in 7% in sclerotherapy patients and 44% of control patients (p < 0.01). In the sclerotherapy group 59% died, and in the control group 51% (n.s.). In both groups, the mortality rate increased with the severity of liver function impairment. Sclerotherapy was not found to improve survival in patients, irrespective of the etiology of cirrhosis (alcoholic or nonalcoholic) or variceal size (low-grade or high-grade). We conclude that sclerotherapy is a suitable method to reduce the occurrence of the first variceal hemorrhage, but it does not appear to have an effect on survival. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/7712966/Prophylactic_sclerotherapy_for_esophageal_varices:_long_term_results_of_a_prospective_study_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-1009084 DB - PRIME DP - Unbound Medicine ER -