Usefulness of endoscopic sclerotherapy with N-butyl-2-cyanoacrylate for perforating vein closure in esophageal varices

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  • 食道静脈瘤の貫通静脈閉鎖にN-butyl-2-cyanoacrylateを併用した内視鏡的硬化療法
  • ショクドウ ジョウミャクリュウ ノ カンツウ ジョウミャク ヘイサ ニ N-butyl-2-cyanoacrylate オ ヘイヨウ シタ ナイシキョウテキ コウカ リョウホウ

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Abstract

<p>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.</p>

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