Taniai N, Onda M, Tajiri T, Yoshida H, Mamada Y
First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyou-ku, Tokyo 113-8603, Japan.
Hepatogastroenterology. 2001 Jan-Feb;48(37):133-6.
BACKGROUND/AIMS: We investigated the impact long-term prognosis of combined interventional radiology and endoscopic therapy in patients with esophageal varices.
Patients with recurrent esophageal varices underwent treatment as follows: 54 were treated with endoscopic therapy alone and 32 underwent endoscopic therapy plus interventional radiologic procedures. Primary endpoints during 5-year follow-up included recurrent bleeding, second retreatment, and death.
The bleeding rates were 11.1% in the endoscopy group, and 9.4% in the combined therapy group. Second retreatment rates at 1 year, 3 years, and 5 years in the endoscopy group and combined therapy group were 25.4% and 17.2%, 70.2% and 39.3%, and 85.0% and 69.6%, respectively. The second retreatment rates in the combined therapy group were significantly reduced compared to the endoscopy alone group (P = 0.05). Cumulative retreatment rates in Child's class C cases were significantly lower in the combined therapy group than in the endoscopy group (P = 0.01). Survival at 3 years was 97.1% in the endoscopy group and 92.0% in the combined therapy group, and 5-year survival was 79.1% and 83.6%, respectively.
The combination of interventional radiologic and endoscopic therapy is highly effective and improves long-term prognosis in patients with recurrent esophageal varices.
背景/目的：我们研究了联合介入放射学和内镜治疗对食管静脉曲张患者长期预后的影响。
复发性食管静脉曲张患者接受如下治疗：54例仅接受内镜治疗，32例接受内镜治疗加介入放射学操作。5年随访期间的主要终点包括再出血、二次治疗和死亡。
内镜治疗组的出血率为11.1%，联合治疗组为9.4%。内镜治疗组和联合治疗组1年、3年和5年的二次治疗率分别为25.4%和17.2%、70.2%和39.3%、85.0%和69.6%。联合治疗组的二次治疗率与单纯内镜治疗组相比显著降低（P = 0.05）。联合治疗组Child C级病例的累积再治疗率显著低于内镜治疗组（P = 0.01）。内镜治疗组3年生存率为97.1%，联合治疗组为92.0%，5年生存率分别为79.1%和83.6%。
介入放射学与内镜治疗相结合非常有效，可改善复发性食管静脉曲张患者的长期预后。
