Sato Wataru, Kamada Kentaro, Goto Takashi, Ohshima Shigetoshi, Miura Kouichi, Shibuya Tomomi, Dohmen Takahiro, Kanata Ryo, Sakai Toshitaka, Chiba Mitsuru, Sugimoto Yuko, Minami Shinichiro, Ishiyama Koichi, Hashimoto Manabu, Ohnishi Hirohide
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan.
Intern Med. 2015;54(3):261-5. doi: 10.2169/internalmedicine.54.3465.
We evaluated the efficacy and safety of balloon-occluded retrograde transvenous obliteration (B-RTO) performed using absolute ethanol with iodized oil (ET+LPD) and simultaneous endoscopic injection sclerotherapy (EIS) with cyanoacrylate (CA) for gastric varices (GVs).
A total of 16 patients with endoscopically proven high-risk GVs treated using combined B-RTO with ET+LPD and EIS with CA between January 2007 and July 2012 were enrolled.
Twelve cases included GVs involving both the cardia and fundus, two cases included fundal varices and two cases included cardiac varices. In terms of the form of GVs, 10 cases involved F2 lesions and six cases involved F3 lesions. The flow vein was the left gastric vein in 13 cases and the posterior gastric vein in three cases. The drainage route was a splenorenal shunt in all cases. The average dose of ET+LPD was 12.0 mL, while that of CA was 2.45 mL. All complications were transient, and no major complications occurred after the procedures. None of the patients experienced bleeding or recurrence of gastric varices after the combined B-RTO and EIS procedures during an average follow-up period of 38.3 months.
Combined B-RTO with ET+LPD and simultaneous EIS with CA is considered to be an effective and safe procedure for treating GVs.
我们评估了使用碘化油乙醇（ET+LPD）进行球囊闭塞逆行静脉闭塞术（B-RTO）以及同时使用氰基丙烯酸酯（CA）进行内镜注射硬化治疗（EIS）治疗胃静脉曲张（GVs）的疗效和安全性。
纳入2007年1月至2012年7月间16例经内镜证实为高危GVs且接受B-RTO联合ET+LPD及EIS联合CA治疗的患者。
12例患者的GVs累及贲门和胃底，2例为胃底静脉曲张，2例为贲门静脉曲张。就GVs的形态而言，10例为F2级病变，6例为F3级病变。血流静脉为胃左静脉13例，胃后静脉3例。引流途径均为脾肾分流。ET+LPD的平均剂量为12.0 mL，CA的平均剂量为2.45 mL。所有并发症均为短暂性，术后未发生严重并发症。在平均38.3个月的随访期内，联合B-RTO和EIS术后无一例患者出现胃静脉曲张出血或复发。
B-RTO联合ET+LPD及同时EIS联合CA被认为是治疗GVs的一种有效且安全的方法。
