10278
document
Endoscopic ligation compared with sclerotherapy for bleeding esophageal varices in children with extrahepatic portal venous obstruction . Endoscopic sclerotherapy is an effective treatment for bleeding esophageal varices , but it is associated with significant complications . Endoscopic ligation , a new form of endoscopic treatment for bleeding varices , has been shown to be superior to sclerotherapy in adult patients with cirrhosis . To determine the efficacy and safety of endoscopic sclerotherapy and ligation , the 2 methods were compared in a randomized control trial in 49 children with extrahepatic portal venous obstruction who had proven bleeding from esophageal varices . Twenty-four patients were treated with sclerotherapy and 25 with band ligation . No significant differences were found between the sclerotherapy and ligation groups in arresting active index bleeding ( 100 % each ) and achieving variceal eradication ( 91.7 % vs. 96 % , P =.61 ) . Band ligation eradicated varices in fewer endoscopic sessions than did sclerotherapy ( 3.9 +/- 1.1 vs. 6.1 +/- 1.7 , respectively , P < .0001 ) . The rebleeding rate was significantly higher in the sclerotherapy group ( 25 % vs. 4 % , P =.049 ) , as was the rate of major complications ( 25 % vs. 4 % , P =.049 ) . After eradication , esophageal variceal recurrence was not significantly different in patients treated by ligation than by sclerotherapy ( 17.4 % vs. 10 % , P =.67 ) . In conclusion , variceal band ligation in children is a safe and effective technique that achieves variceal eradication more quickly , with a lower rebleeding rate and fewer complications compared with sclerotherapy .
10279
Intervention_Surgical
Endoscopic ligation
10280
Intervention_Pharmacological
sclerotherapy
10281
Intervention_Pharmacological
Endoscopic sclerotherapy
10282
Intervention_Surgical
Endoscopic ligation
10283
Intervention_Pharmacological
sclerotherapy
10284
Intervention_Surgical
band ligation .
10285
Intervention_Surgical
variceal band ligation
10286
Outcome_Physical
bleeding esophageal varices
10287
Outcome_Adverse-effects
significant complications
10288
Outcome_Other
efficacy and safety
10289
Outcome_Physical
arresting active index bleeding
10290
Outcome_Physical
achieving variceal eradication
10291
Outcome_Adverse-effects
varices
10292
Outcome_Other
endoscopic sessions
10293
Outcome_Adverse-effects
rebleeding rate
10294
Outcome_Adverse-effects
rate of major complications
10295
Outcome_Other
esophageal variceal recurrence
10296
Outcome_Other
safe and effective
10297
Outcome_Other
variceal eradication
10298
Outcome_Physical
rebleeding rate
10299
Outcome_Adverse-effects
complications
10300
Participant_Age
children
10301
Participant_Condition
extrahepatic portal venous obstruction
10302
Participant_Sample-size
49
10303
Participant_Condition
extrahepatic portal venous obstruction
10304
Participant_Condition
bleeding from esophageal varices
10305
Participant_Sample-size
Twenty-four
10306
Participant_Sample-size
25
10307
Participant_Age
children