Endoscopic Treatment of Esophageal Varices: Suzuki Method
The Suzuki method was established in 1979 and is a unique intra- and para-variceal combined injection technique using 1% polidocanol (Aethoxysclerol).
From 1979 to 1987, we performed this procedures a total 878 times on 276 patients. There were 94 emergency, 92 elective, and 90 prophylactic cases.
We use Aethoxysclerol as the safest sclerosant since it has low toxicity and low viscosity. The injections are first made into a submucosal site between the varices and then into each variceal channel, using 3 mL in each injection. The total dose of sclerosant is limited to 30 mL per one session of therapy. We perform the endoscopic injection sclerotherapy (EIS) by freehand technique without any sheath or balloon, using a flexible 23 or 25 gauge fine needle under intravenous sedation and topical anesthesia. As a rule, three sessions of EIS are performed at weekly intervals, and a follow-up study is done every 3 months for choosing additional therapy or observation.
As a result, the hemostatic rate was as high as 91% and the eradicating rate was 92%.
The Suzuki method is an effective treatment for both acute variceal bleeding and bleeding prophylaxis.
KeywordsEIS Esophageal varices Endoscopic sclerotherapy Aethoxysclerol Polidocanol
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