[Outcome of patients after obliteration of esophageal varices by endoscopic sclerosis. Results of a prospective study]. / Devenir des malades après éradication des varices oesophagiennes par sclérose endoscopique. Résultats d'une étude prospective.

The purpose of this prospective was study to investigate the course of patients after obliteration of bleeding esophageal varices by endoscopic sclerotherapy and to outline prognostic factors. Sixty-seven patients (45 men, 22 women, mean age: 53.3 +/- 14 years) were followed for a mean of 14 +/- 8 months median = 15 months-range: 1-33 months) from the time of obliteration. Etiology of portal hypertension was portal vein thrombosis in 3 patients and cirrhosis in 64, 44 of whom (65 p. 100) were due to alcoholism (Child-Pugh's class: A: 8 p. 100, B: 42 p. 100, C: 50 p. 100). Recurrence of varices was observed in 23 patients within 1.4 to 25 months (median: 6.6 months). The recurrence rate increased in a linear fashion with time. Reobliteration was achieved in one to three sessions of sclerotherapy. More than one bleeding episodes was observed more often, before sclerotherapy (p less than 0.05) and esophageal stenosis was seen less often during treatment (p less than 0.05) than in patients without recurrence. Variceal bleeding occurred in 14 patients (21 p. 100) within 0.1 to 23 months (median = 5.6), 6 of whom (43 p. 100) died. In the subgroup of alcoholic cirrhosis, absence of withdrawal was associated with a higher risk of rebleeding (p = 0.04). Fifteen patients (22 p. 100) died within 1 to 26 months (median = 12.3). They had a higher mean age (p less than 0.01) and a lower blood fibrinogen (p less than 0.05) than survivors.(ABSTRACT TRUNCATED AT 250 WORDS)