End point for sclerosis of esophageal varices. 1993

B K Agrawal, and A Suman, and V Singh, and P Kumar
Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna.

BACKGROUND Small esophageal varices are difficult to inject intravariceally and complete eradication of varices may not be therapeutically necessary. METHODS A prospective study designed to compare the use of different end points of sclerotherapy ie (i) total eradication (grade 0) (ii) grade I varices or (iii) grade II white (IIw) varices, by stopping variceal injection when one of these was reached. The patients were followed endoscopically and clinically at 3-4 mo intervals. METHODS Variceal recurrence and rebleeding rates. RESULTS Of 266 patients with portal hypertension (147 cirrhosis, 51 non-cirrhotic portal fibrosis, 68 extra-hepatic portal venous obstruction), 232 (87.2%) reached one of the three end points--six to grade 0, 96 to grade I and 130 to grade IIw. Among 212 patients followed up for a mean post-sclerotherapy period of 12.2 mo (range 3-48 mo), variceal recurrence rates, time intervals to recurrence and rebleed rates were comparable in patients with endpoints of grade I and grade II (white) varices (28.5% vs 38.9%, 10.8 mo vs 9.2 mo, and 7.7% vs 7.8%, respectively; all p = ns). Overall, 51 patients had interval bleed before reaching the end point--50 (98%) of them bled from grade III and IV varices while only one patient (2%) bled with grade IIw varices. CONCLUSIONS Grade I or grade IIw varices should be acceptable as the end points for endoscopic sclerotherapy of esophageal varices.

UI MeSH Term Description Entries
D008297 Male Males
D011092 Polyethylene Glycols Polymers of ETHYLENE OXIDE and water, and their ethers. They vary in consistency from liquid to solid depending on the molecular weight indicated by a number following the name. They are used as SURFACTANTS, dispersing agents, solvents, ointment and suppository bases, vehicles, and tablet excipients. Some specific groups are NONOXYNOLS, OCTOXYNOLS, and POLOXAMERS. Macrogols,Polyoxyethylenes,Carbowax,Macrogol,Polyethylene Glycol,Polyethylene Oxide,Polyethyleneoxide,Polyglycol,Glycol, Polyethylene,Glycols, Polyethylene,Oxide, Polyethylene,Oxides, Polyethylene,Polyethylene Oxides,Polyethyleneoxides,Polyglycols,Polyoxyethylene
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D004932 Esophageal and Gastric Varices Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL). Esophageal Varices,Gastric Varices,Esophageal Varix,Gastric Varix,Varices, Esophageal,Varices, Gastric,Varix, Esophageal,Varix, Gastric
D005260 Female Females
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077423 Polidocanol An alkyl polyglycol ether of LAURYL ALCOHOL, chemically defined as an alcohol ethoxylate having an average alkyl chain of 12–14 carbon atoms, and an ethylene oxide chain of 9 ethylene oxide units. It is used as a detergent, and medically as a local anesthetic, and as a sclerosing agent for the treatment of ESOPHAGEAL AND GASTRIC VARICES and VARICOSE VEINS. Aethoxysclerol,Aethoxysklerol,Aetoxisclerol,Atossisclerol,Atoxysclerol,Brij 30,Brij-30,Dodecyl Ethyleneglycol Monoether,Ethoxysclerol,Hydroxypolyethoxydodecane,Laureth,Laureth 9,Laureth-1,Laureth-4,Laureth-7,Laureth-9,Lauromacrogol,Lauromacrogol 400,Lauromacrogols,Lubrol 12A9,Lubrol-PX,Nonaethylene Glycol Monododecyl Ether,Nonaethyleneglycol Monododecyl Ether,Polyethylene Glycol Monododecyl Ether,Polyethylene Glycol-7-lauryl Ether,Polyoxyethylene 9-lauryl Ether,Polyoxyethylene Lauryl Ether,Polyoxyethylene(4) Lauryl Ether,Polyoxyethylene-4-dodecyl Ether,Polyoxyethylenedodecyl Ether,Tetraethylene Glycol Dodecyl Ether,Tetraethyleneglycol Lauryl Ether,Thesit,alpha-Dodecyl-omega-hydroxypoly(oxy-1,2ethanediyl),Brij30,Dodecyl Ethyleneglycol Monoethers,Ether, Nonaethyleneglycol Monododecyl,Ether, Polyethylene Glycol-7-lauryl,Ether, Polyoxyethylene 9-lauryl,Ether, Polyoxyethylene Lauryl,Ether, Polyoxyethylene-4-dodecyl,Ether, Tetraethyleneglycol Lauryl,Ethyleneglycol Monoether, Dodecyl,Laureth 1,Laureth 4,Laureth 7,Laureths,Lauryl Ether, Tetraethyleneglycol,Lubrol PX,Monododecyl Ether, Nonaethyleneglycol,Monoether, Dodecyl Ethyleneglycol,Nonaethyleneglycol Monododecyl Ethers,Polidocanols,Polyethylene Glycol 7 lauryl Ether,Polyethylene Glycol-7-lauryl Ethers,Polyoxyethylene 4 dodecyl Ether,Polyoxyethylene 9 lauryl Ether,Polyoxyethylene 9-lauryl Ethers,Polyoxyethylene Lauryl Ethers,Polyoxyethylenedodecyl Ethers,Tetraethyleneglycol Lauryl Ethers
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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