2020 Volume 26 Issue 1 Pages 29-34
In endoscopic sclerotherapy for esophageal varices, perforating veins can interfere with hemostasis during treatment and cause difficulties in completing the procedure, leading to short-term recurrence. We devised a method for closing perforating veins identified by preoperative ultrasonic endoscopy with N-butyl-2-cyanoacrylate (NBCA) to enable conventional sclerotherapy. In total, there were 22 patients with a preoperatively identified perforating vein; 9 cases were closed with NBCA (Group A), and 13 cases were closed by other means (ethanol, endoscopic ligation, balloon tamponade) (Group B); these groups were compared The average dose of sclerosant was significantly lower in Group A (8.3 ml) compared to group B (12.2 ml, p=0.038). The consolidation rate after 3 months was also significantly lower in group A (22.2% in group A vs. 76.9% in group B, p=0.036). Group A also had shorter treatment times, less treatment frequency, and fewer hospital days than B group and showed better results in invasiveness and treatment content. Using NBCA for perforating vein closure enabled reliable hemostasis, safe completion of a series of sclerotherapy procedures, and improved curative possibility.
