Abstract
To further reduce the rate of recurrence following the eradication of esophageal varices with endoscopic injection sclerotherapy using ethanolamine oleate (EO)-aethoxysklerol (AS) combination method, we introduced the consolidation method (mucosal fibrosis method using AS, laser, or argon plasma coagulation (APC)). The consolidation method for esophageal varices consists essentially of complete disappearance of esophageal varices using the EO-AS combination method followed by fibrosing of the lower esophagus with AS, laser, or APC. APC consolidation has been widely performed to date due to its usability and efficacy in further preventing variceal recurrence. Although the whole lower esophagus is treated including thrombotic varices and normal esophageal mucosa, this method can make fibrosis all round in the esophageal wall without esophageal stenosis. APC has also been used to prevent recurrence after endoscopic variceal ligation and is reported to be effective.
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References
Obara K, Masaki M, Sakamoto H, Iwasaki K, Mitsuhashi H, Orikasa K, et al. Studies on prognosis of patients with esophageal and gastric varices treated with injection sclerotherapy using EO or EO-AS combination method. Gastroenterol Endosc. 1987;29:2232–6. [in Japanese with English abstract].
Obara K, Ohira H, Sakamoto H, Iwasaki K, Mitsuhashi M, Suzuki S, et al. A new method of sclerotherapy for esophagogastric varices: EO-AS combination method followed by mucosa-fibrosis with AS. Gastroenterol Endosc. 1981;31:2977–81. [In Japanese with English abstract].
Obara K, Kojima T, Irisawa A, Watanabe S, Kuwana T, Kogure A, et al. A new method of sclerotherapy for esophageal varices: EO-AS combination method followed by mucosa-fibrosing with laser. Gastroenterol Endosc. 1994;36:716–21. [In Japanese with English abstract].
Grund KE, Storek D, Farin G. Endoscopic argon plasma coagulation (APC): first clinical experiences in flexible endoscopy. Endosc Surg Allied Technol. 1994;2:42–6.
Obara K, Toyonaga A, Kokubu S. Guidelines for the endoscopic treatment of esophagogastric varices. In: Society for Japanese Gastroenterological Endoscopy, editor. Guidelines for gastrointestinal endoscopy. 3rd ed. Tokyo: Igaku-Shoin; 2006. p. 215–34. [in Japanese].
The Liver Cancer Study Group of Japan. The general rules for the clinical and pathological study of primary liver cancer, second English edition. Tokyo: Kanehara & Co., Ltd.; 2003.
Irisawa A, Saito A, Obara K, Shibukawa G, Takagi T, Shishido H, et al. Endoscopic recurrence of esophageal varices is associated with the specific EUS abnormalities: severe periesophageal collateral veins and large perforating veins. Gastrointest Endosc. 2001;53:77–84.
Obara K. Endoscopic EV treatment. Endoscopic treatment of esophagogastric varices. Tokyo: Narunia Inc.; 2016. p. 21–46.
Obara K. Endoscopic injection sclerotherapy followed by mucosal fibrosis. JJPH. 2002;8:128–35. [In Japanese].
Obara K, Kasukawa R. Endoscopic ultrasonography for evaluation of patients treated by endoscopic injection sclerotherapy. Endosc Digest. 1990;2:1395–403. [In Japanese with English abstract].
Kikuchi Y. Pathological change of esophageal wall after argon plasma coagulation therapy for esophageal varices. JJPH. 2003;9:73–7. [in Japanese].
Obara K. Esophagogastric varices: indication, treatment procedure and outcomes. J Jpn Soc Intern Med. 2003;92(1):58–65. [In Japanese].
Tajiri T, Yoshida H, Obara K, Onji M, Kage M, Kitano S, et al. General rules for recording endoscopic findings of esophagogastric varices (2nd edition). Dig Endosc. 2010;22(1):1–9. https://doi.org/10.1111/j.1443-1661.2009.00929.X.
The Japan Society for Portal Hypertension. The general rules for study of portal hypertension. 3rd ed. Tokyo: Kanehara & Co., Ltd; 2013. p. 37–62. [in Japanese].
Deguchi H, Kato J, Maeda Y, Moribata K, Shingaki N, Niwa T, et al. Argon plasma coagulation is effective for prevention of recurrent esophageal varices after endoscopic injection sclerotherapy: single-center case-control study. Dig Endosc. 2016;28:42–9. https://doi.org/10.1111/den.12538.
Matsui S, Kudo M, Nakaoka R, Shiomi M. Effect of mucosa-fibrosing therapy with argon plasma coagulation on esophageal varices. JJPH. 2003;8:180–4. [In Japanese with English abstract].
Harras F, Sheta S, Shehata M, Saadany S, Selim M, Mansour L. Endoscopic band ligation plus argon plasma coagulation versus scleroligation for eradication of esophageal varices. J Gastroenterol Hepatol. 2010;25:1058–65. https://doi.org/10.1111/j.1440-1746.2010.06265.x.
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Obara, K. (2019). Endoscopic Treatment of Esophageal Varices: Consolidation Method Following Ethanolamine Oleate-Aethoxysklerol Combination Therapy. In: Obara, K. (eds) Clinical Investigation of Portal Hypertension. Springer, Singapore. https://doi.org/10.1007/978-981-10-7425-7_25
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DOI: https://doi.org/10.1007/978-981-10-7425-7_25
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