Curative Efficacy Of Endoscopic Selective Varices Devascularization For Esophagogastric Varicose

Objective: The study was designed to assess the clinical efficacy of endoscopic selective varices devascularization(ESVD)and traditional sequential therapy in the esophagogastric varicose.Methods: A total of 64 patients were treated under endoscope for esophagogastric varicose in the digestive department of Nan Xishan Hospital Guangxi Zhuang Autonomous Region from October 2014 to September 2017,who were divided into two groups.Of them,Control group:thirty-nine patients were treated with the traditional sequential therapy(esophageal varicose sclerotherapy +tissue adhesive by sandwich injection method in gastric varices);The observation group:twenty-five patients were therapied with esophagogastric selective varices devascularization(lauromacrogol-tissue adhesive-air-normal saline).The clinical data and general situation of all cirrhotic patients with esophageal varices were recorded and analyzed,including gender,age,etiology of cirrhosis,Child-Pugh score and Sarin classification,and the hemostasis success rate,vanishing rate of varicose veins,overall complication rate,rebleeding rate and times of treatment,followed by comparison between the two groups.Results: In this study,64 patients were collected,and there was no significant difference in the clinical data and general situation of the patients.All patients were followed up for 6 months.In the control group,the average times of treatments were 2.76±0.83,the average of lauromacrogol were 43.45±23.16 ml and tissue adhesive were 2.0(1.5-4.0)ml.In the observation group,the average times of treatments were 1.52±0.58,the average of lauromacrogol were 46.36±26.35 ml and tissue adhesive were 3.0(1.75-4.5)ml.The total number of treatment in the observation group was statistically less than that in the control group.(P< 0.01).The hemostasis rates of two groups were both 100%,the rebleeding rates of were 17.9%(7/39)and 12.0%(3/25),and there was no significant difference among the two groups(P> 0.05).Postoperative venous disappearance rates were 15.4%(6/39)and 40.0%(10/25)respectively,and the difference was statistically significant(P< 0.05).In the control group,there were 19 cases(48.7%)with complications,including 4 cases of fever,11 cases of esophageal ulcers and 4 cases of postoperative pain in the sternum.There were 10 cases(40%)with complications in the observation group,including 2 cases of fever,6 cases of esophageal ulcers and 2 cases of poststernal pain.There was no statistical significance in the postoperative complications between the two groups(P>0.05).Conclusions: ESVD and traditional sequential injection harbored a reliable hemostatic effect.Most of the postoperative complications were mild,which could be relieved and prevented.ESVD is superior to traditional sequential injection in the total number of treatment and the vanishing rate of varicose veins,low recurrence rate,few times of treatment patients have good dependence,save the cost of medical treatment,and enrich the diagnosis and treatment of esophageal variceal bleeding.