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. 2010:3:159-63.
doi: 10.2147/CEG.S15401. Epub 2010 Dec 2.

Retrospective analysis of endoscopic injection sclerotherapy for rectal varices compared with band ligation

Takahiro Sato  1 , Katsu Yamazaki, Jun Akaike, Jouji Toyota, Yoshiyasu Karino, Takumi Ohmura
Affiliations

Retrospective analysis of endoscopic injection sclerotherapy for rectal varices compared with band ligation

Takahiro Sato et al. Clin Exp Gastroenterol. 2010.

Abstract

Background and aims: The study's aim was to evaluate the efficacy of endoscopic injection sclerotherapy (EIS) compared with endoscopic band ligation (EBL) in treating rectal varices.

Methods: Data from 34 consecutive patients who underwent endoscopic treatments for rectal varices were analyzed. The clinical outcomes, including complications, related to EIS or EBL retrospectively.

Results: In 25 of the 34 patients, EIS was performed weekly 2-5 times (mean, 2.7), and the total amount of sclerosant ranged from 3.2 to 12.0 mL (mean, 5.2 mL). After EIS, colonoscopy revealed shrinkage of the rectal varices in all 25 patients, with no complications reported. In 9 of the 34 patients, EBL was performed weekly 1-3 times (mean, 2.2), and bands were placed on the varices at 2-12 sites (mean, 8.0). After EBL, colonoscopy revealed ulcers and shrinkage of the rectal varices in all nine patients, eight of whom experienced no operative complications. The overall recurrence rate for rectal varices was 10 of 24 (41.7%), including 5 of 9 (55.6%) receiving EBL and 5 of 15 (33.3%) receiving EIS, over a 1-year follow-up period (n = 24). All four patients with recurrence of bleeding were EBL cases, versus no EIS cases (P < 0.05).

Conclusion: EIS appears superior to EBL with regard to effectiveness and complications after endoscopic treatment of rectal varices.

Keywords: endoscopic band ligation; endoscopic injection sclerotherapy; portal hypertension; rectal varices.

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Figures

Figure 1
Figure 1
A) Cb, F2, RC-positive rectal varices. B) Fluoroscopic observation with infusion of 5% EOI was performed to determine the extent of the varices. C) One week after, fluoroscopic observation with infusion of 5% EOI. Abbreviations: Cb, blue; EIS, endoscopic injection sclerotherapy; EOI, ethanolamine oleate with iopamidol; F2, enlarged and tortuous; RC, red color.
Figure 2
Figure 2
After EIS colonoscopy revealed shrinkage of the rectal varices.
Figure 3
Figure 3
Colonoscopy revealed bleeding from ulcers after endoscopic band ligation.
Figure 4
Figure 4
Recurrence with bleeding-free survival rate was calculated by the Kaplan–Meier method for between-group comparisons.
See this image and copyright information in PMC

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