Effect of intravariceal sclerotherapy combined with esophageal mucosal sclerotherapy using small-volume sclerosant for cirrhotic patients with high variceal pressure

AIM:To explore the effect of intravariceal-mucosal sclerotherapy using small dose of sclerosant on the recurrence of esophageal varices.METHODS:We randomly assigned 38 cirrhotic patients with previous variceal bleeding and high variceal pressure(> 15.2 mm Hg) to receive endoscopic variceal ligation(EVL) and combined intravariceal and esophageal mucosal sclerotherapy(combined group) using small-volume sclerosant.The end-points of the study were rebleeding and recurrence of esophageal varices.RESULTS:During a median follow-up period of 16 mo,varices recurred in 1 patient in the combined group as compared with 7 patients in the EVL group(P =0.045).Rebleeding occurred in 3 patients in the EVL group as compared with 1 patient in the combined group(P=0.687).No patient died in the two groups.No significant differences were observed between the two groups with respect to serious adverse events.CONCLUSION:Intravariceal-mucosal sclerotherapy using small dose of sclerosant is more effective than EVL in decreasing the incidence of variceal recurrence for cirrhotic patients.