11-YEAR SURVEY OF SAFETY AND EFFICACY OF ENDOSCOPIC INJECTION SCLEROTHERAPY USING 2-PERCENT SODIUM TETRADECYL SULFATE AND CONTRAST-MEDIUM

We conducted a retrospective 11-year survey to evaluate the post-treat ment course in 285 patients with esophagogastric varices following adm inistration of endoscopic injection sclerotherapy as an emergency, ele ctive, or prophylactic procedure using freshly prepared 2% sodium tetr adecyl sulfate not containing benzyl alcohol. These agents were inject ed into the varices and the supplying veins under fluoroscopic observa tion, usually in a single treatment. In all patients the variceal size was greatly reduced following one treatment. The amount of sclerosant necessary to fill the varices and the supplying veins varied widely a mong the patients. Acute variceal bleeding was controlled in 80 (96.4% ) of the 83 patients, and the risk of rebleeding during the first mont h was 0.0548 in the emergency procedures. The serious complication of perforation was observed in one patient. The cause of death was establ ished in the 122 patients who died and included esophageal variceal bl eeding in eight (6.6%) and gastric variceal bleeding in one (0.8%). Th e overall 50% survival period was 5 years and 4 months. Multivariate a nalysis disclosed that the factors with the greatest negative effect o n survival were poor hepatic status and the presence of hepatocellular carcinoma. The method of preparation and the procedure itself may be considered safe and effective in the treatment of esophagogastric vari ces.