Abstract
We have experienced the recurrent esophageal varices of superficial F0 type after endoscopic treatment. We treated these recurrent varices by endoscopic variceal electrocoagulation (EVEC) using the ordinary monopolar system and argon plasma coagulation (APC). We discussed therapeutic effect and usefulness of EVEC in comparison with those by endoscopic injection sclerotherapy with 1% polidocanol (1% AS-EIS). We performed randomized prospective comparative study on EVEC and 1% AS-EIS with the F0RC (+) recurrent esophageal varices in 30 patients, respectively. In a 12 months follow-up after treatment, the cumulative recurrence free rate was more frequently observed in was 79.1% in the EVEC group and 72.7% in the 1% AS-EIS group. Although pyrexia was more frequently observed in patients treated by EVEC, dysphagia and retrosternal pain were significantly less common in the EVEC group than in the 1% AS-EIS group (p<0.05). As a consequence of the treatment we observed the thickening of mucosal and submucosal layers visualized as slight hyperechoic area by endoscopic ultrasonography, and the thickening of submucosal layers with fibrosis by pathological study of autopsy specimen. These observation suggest that EVEC is easier to manipulate than 1% AS-EIS and can eradicate F0 RC (+) esophageal varices more directly. Furthermore, APC is more useful for EVEC was more useful method for EVEC. In conclusion, EVEC is convenient and raliable therapy for F0RC (+) recurrent esophageal varices.
