Yoshida Hiroshi, Mamada Yasuhiro, Taniai Nobuhiko, Yamamoto Kazuhito, Kawano Youichi, Mizuguchi Yoshiaki, Shimizu Tetsuya, Takahashi Tsubasa, Tajiri Takashi
Department of Surgery 1, Nippon Medical School, Tokyo, Japan.
Am J Gastroenterol. 2005 Sep;100(9):2005-9. doi: 10.1111/j.1572-0241.2005.41864.x.
Endoscopic variceal ligation (EVL) is a safe and simple procedure now being used on a widening scale. Yet most patients who undergo endoscopic treatment for esophageal varices eventually require additional treatment for recurrent varices. In this study, we investigated and compared the efficacy and long-term results of EVL performed in three treatments with a total of sixteen O-rings at two different intervals; bi-weekly (once every 2 wk: the conventional interval) and bi-monthly (once every 2 months). A total of 63 patients with esophageal varices were randomly assigned to groups receiving bi-weekly or bi-monthly EVL treatment. Optimal medical therapy was assessed by one medical doctor who was unaware of the patients' treatment assignments. Three parameters of treatment outcome were evaluated: the rate of recurrence, rate of additional treatment, and overall survival. The overall rates of variceal recurrence and additional treatment were both higher in the bi-weekly group than in the bi-monthly group (p < 0.001). In conclusion, EVL performed for the treatment of esophageal varices at bi-monthly intervals brought about better results than the same treatment performed at bi-weekly intervals. The treatments intercalated by the longer interval obtained a higher total eradication rate, lower recurrence rate, and lower rate of additional treatment.
内镜下静脉曲张结扎术（EVL）是一种安全且简单的手术，目前正在越来越广泛地应用。然而，大多数接受内镜治疗食管静脉曲张的患者最终仍需要对复发性静脉曲张进行额外治疗。在本研究中，我们调查并比较了在两种不同间隔下进行三次共使用16个O形环治疗的EVL的疗效和长期结果；每两周一次（每2周一次：传统间隔）和每两个月一次（每2个月一次）。共有63例食管静脉曲张患者被随机分配到接受每两周或每两个月一次EVL治疗的组中。由一名不了解患者治疗分配情况的医生评估最佳药物治疗。评估了治疗结果的三个参数：复发率、额外治疗率和总生存率。每两周治疗组的静脉曲张复发率和额外治疗率均高于每两个月治疗组（p < 0.001）。总之，每两个月进行一次的EVL治疗食管静脉曲张的效果优于每两周进行一次的相同治疗。间隔时间较长的治疗获得了更高的总根除率、更低的复发率和更低的额外治疗率。
