Lu Huan-yuan, Liu Xun-yang, Huang Fei-zhou, Nie Wan-pin, Ren Shu-ping, Huang Rang-lang
Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Zhonghua Wai Ke Za Zhi. 2004 Dec 22;42(24):1513-5.
To investigate the prevention of esophageal varices recurrence by laser inducing esophageal mucosal fibrosis.
Our study included 42 patients after esophageal varices eradicated by endoscopic varices ligation, and they were divided into 2 groups randomly, each group included 21 patients. One group was assigned to received laser treatment, and indocyanine green solution (1 mg/ml) was injected submucosally, a diode laser (power 10 watts) was applied to the surface from the esophagogastric junction to 5 cm above it. Another group was controlling without any treatments. All patient were followed up by endoscopy every 3 months until 12 months.
Laser irradiation was performed safely without any major complications. And lower esophageal mucosa produced fibrosis widely after laser irradiated 1 month. After 12 months follow up, the cumulative recurrence rate was significantly lower than the control group, 14% (3/21) vs 43% (9/21) (chi(2) = 4.20, P < 0.05).
Our study indicates that laser inducing mucous fibrosis is safely and can prevent recurrence of esophageal varices.
探讨激光诱导食管黏膜纤维化预防食管静脉曲张复发的效果。
本研究纳入42例经内镜下静脉曲张结扎术根除食管静脉曲张后的患者，将其随机分为2组，每组21例。一组接受激光治疗，黏膜下注射吲哚菁绿溶液（1mg/ml），使用二极管激光（功率10瓦）从食管胃交界处向上至其上方5cm对表面进行照射。另一组为对照组，不进行任何治疗。所有患者每3个月接受一次内镜随访，直至12个月。
激光照射操作安全，未出现任何严重并发症。激光照射1个月后，食管下段黏膜广泛出现纤维化。随访12个月后，累积复发率显著低于对照组，分别为14%（3/21）和43%（9/21）（χ² = 4.20，P < 0.05）。
我们的研究表明，激光诱导黏膜纤维化安全可行，可预防食管静脉曲张复发。
