A primary study of 83 cases undergoing endoscopic selective varices devascularization / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the clinical efficacy and safety of endoscopic selective varices devascularization. Methods A retrospective analysis was performed on the data of 153 cirrhosis patients with esophagogastric varices undergoing endoscopic treatment. The traditional treatment group with 70 cases underwent traditional "sandwich method"(lipiodol?tissue adhesive?lipiodol), and the selective treatment group with 83 cases was treated by modified"sandwich method"(lauromacrogol?tissue adhesive?saline)with selective varices devascularization.The improvement rate,effective rate,significant effective rate,rebleeding rate and complications were compared between the two groups.Results One month after treatment,28 cases (47.8%)were significant effective and 15 cases(19.6%)were effective in the traditional treatment group;and 48 cases(60.0%)were significant effective and 24 cases(20.0%)were effective in the selective treatment group. The difference on effective rate and significant effective rate was statistically significant (rs=-0.260,P=0.001). Improvement rate of the traditional treatment group and selective treatment group was 61.4%(43/70)and 86.7%(72/83)respectively,and the difference was statistically significant(χ2=11.626,P=0.001).Within two weeks after treatment, the rebleeding rate of the two group was 8.57%(6/70)and 4.82%(4/83), respectively, and there was no significant difference(bilateral P=0.514, unilateral P=0.271). Within three months after treatment, the rebleeding rate of the traditional treatment group was significantly higher than that of the selective treatment group[21.4%(15/70)VS 9.3%(8/83),χ2=4.133,P=0.042]. No serious complications occurred in the two groups. The incidence of overall complication of the selective treatment group was slightly higher than that of the traditional treatment group [33.7%(28/83)VS 27.1%(19/70)], but the difference was not statistically significant(P>0.05). Conclusion Endoscopic selective varices devascularization has good efficacy and safety, and is worthy of further study.