A NEW EMBOLIC AND SCLEROTIC AGENT(GT-XIII) IN ENDOSCOPIC SCLEROTHERAPY FOR ESOPHAGEAL VARICES.

-COMPARISON WITH COMBINED PROCEDURE WITH GLUCOSE, THROMBIN AND AETHOXYSKLEROL-

Abstract

We have studied the effects and complications of a new type of endoscopic sclerotherapy using GT-XIII as an embolic and sclerotic agent. For the control procedure, combined procedure with glucose, thrombin and aethoxysklerol was administered. This procedure had been performed in our hospital until the new procedure was adopted. Results showed that complete hemostasis for more than 7 days after therapy was obtained in 88% (15 out of 17) of the patients with variceal bleeding. Improvement in the F factor when the RC sign had virtually disappeared was obtained in 74% (60 out of 81) of the patients. Both values were similar to those obtained with the control procedure. As major complications of the procedure, fever exceeding 38°C was observed in 51% of the patients, and pain in the vicinity of the esophagus in 36%. The incidence of esophageal ulcers was 12% (15% for the control procedure), while cerebrovascular diseases were seen in 3 patients. More importantly, there was no occurrence of severe complications such as shock or postoperative bleeding, which were observed in 30% and 6%, respectively, of the patients treated with the control procedure. It was speculated by applying a finger-pieace type ICG clearance meter that GT-XIII was retained at local sites of injection. The embolus containing of GT-XIII-specific particles mixed with hemocytes and organizing thrombus were histologically confirmed in autopsied cases. In conclusion, this procedure is considered simple, safe and effective for the treatment of esophageal varices.