Efficacy And Safety Of Modified Sclerotherapy For Le,g Type Esophagogastric Varices

Objective: To investigate the efficacy and safety of modified sclerotherapy(combined sclerosing agent + tissue gel)and traditional endoscopic treatment of esophagogastric varices(Le,g type of LDRF).Methods: Using a multi-center clinical retrospective study,we selected 194 cases of Le,g-type cirrhosis and esophagogastric varices in the Department of Gastroenterology,the First Affiliated Hospital of Anhui Medical College,the Second Hospital of Fuyang City,and the Hospital of Taihe County in the past 2 years.At endoscopists' discretion,the patients were received esophageal variceal ligation(EVL group),esophageal variceal sclerosis(EIS group),modified sclerosis group(sclerosis + tissue glue + sclerosis).This study aimed to compare the short-term rebleeding rate,variceal disappearance rate and complication rate.Results: Of the 194 patients,93 patients received the modified sclerosing injection,56 patients received EIS,and 45 patients received EVL.The rate of rebleeding in the modified sclerosing group within 3 months(6.5%,6 cases)was lower than that in the EIS group(16.1%,9 cases)and the EVL group(17.8%,8 cases),the difference was statistically significant(?2=6.370 and 7.870,P < 0.05).The rate of rebleeding in the modified sclerosing group within 6 months(9.6%,9 cases)was lower than that in the EIS group(25%,14 cases)and the EVL group(22.2%,10 cases),the difference was statistically significant(?2=8.370 and 8.940,P < 0.05).The rate of disappearance of esophageal varices(EV)in the modified sclerosing group(63.4%)was not significantly different from that in the EIS group(71.4%)and the EVL group(66.7%).The difference was not statistically significant(?2 = 2.310,P> 0.05).Gastric varices(GV)disappeared in the modified sclerosing group(84.9%),which was higher than that in the EIS group(44.6%)and the EVL group(53.3%).The difference was statistically significant(?2= 7.430 and 7.030,P<0.05).The incidence of postoperative complications in the modified sclerosing group(10.8%,10 cases)was significantly higher than that in the EIS group(3.6%,2 cases)and the EVL group(2.2%,1 case),the difference was statistically significant(P<0.05).Postoperative complications of modified sclerotherapy include fever,cerebral embolism,hepatic encephalopathy,and spontaneous peritonitis.Among them,fever(8 cases)is the most common.There were no complications such as major bleeding and death in all patients.Conclusion: If the modified sclerotherapy method is used to treat esophageal varices,the gastric varices can be eliminated more quickly and the rate of rebleeding can be reduced,but the complications should also be taken seriously.