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Brief report| Volume 76, ISSUE 6, P1272-1273, December 2012

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Variceal transection of esophageal varix using the ESD method: new treatment technique for esophageal varix (with video)

Published:February 27, 2012DOI:https://doi.org/10.1016/j.gie.2012.01.007
Variceal transection of esophageal varix using the ESD method: new treatment technique for esophageal varix (with video)
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      Standard treatments for esophageal varices are endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL).
      • Yoshida H.
      • Tajiri T.
      • Mamada Y.
      • et al.
      Comparison of characteristics of recurrent esophageal varices after endoscopic ligation versus endoscopic ligation plus sclerotherapy.
      Hepatogastroenterology. 2004; 51: 457-461
      , 
      • Nishikawa Y.
      • Hosokawa Y.
      • Doi T.
      • et al.
      Evaluation of endoscopic injection sclerotherapy with and without simultaneous ligation for the treatment of esophageal varices.
      J Gastroenterol. 1999; 34: 159-162
      However, EIS or EVL for varices with paraesophageal veins and perforating shunt veins cannot be performed because of the risk of sclerosant leakage.
      • Iso Y.
      • Kawanaka H.
      • Tomikawa M.
      • et al.
      Repeated injection sclerotherapy is preferable to combined therapy with variceal ligation to avoid recurrence of esophageal varices: a prospective randomized trial.
      Hepatogastroenterology. 1997; 44: 467-471
      The recurrence rate of EVL caused by perforating veins is very high.
      • Svoboda P.
      • Kantorová I.
      • Ochmann J.
      • et al.
      A prospective randomized controlled trial of sclerotherapy vs ligation in the prophylactic treatment of high-risk esophageal varices.
      Surg Endosc. 1999; 13: 580-584
      Almost all circumference esophageal cancer on esophageal varices with thick paraesophageal perforating veins can be treated by resecting the cancer en bloc after transecting the esophageal varix with simultaneous endoscopic submucosal dissection (ESD).

      Abbreviations:

      EIS (Endoscopic injection sclerotherapy), ESD (Endoscopic submucosal dissection), EVL (Endoscopic variceal ligation), VTE (variceal transection with ESD)
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      References

        • Yoshida H.
        • Tajiri T.
        • Mamada Y.
        • et al.
        Comparison of characteristics of recurrent esophageal varices after endoscopic ligation versus endoscopic ligation plus sclerotherapy.
        Hepatogastroenterology. 2004; 51: 457-461
        View in Article
        • Nishikawa Y.
        • Hosokawa Y.
        • Doi T.
        • et al.
        Evaluation of endoscopic injection sclerotherapy with and without simultaneous ligation for the treatment of esophageal varices.
        J Gastroenterol. 1999; 34: 159-162
        View in Article
        • Iso Y.
        • Kawanaka H.
        • Tomikawa M.
        • et al.
        Repeated injection sclerotherapy is preferable to combined therapy with variceal ligation to avoid recurrence of esophageal varices: a prospective randomized trial.
        Hepatogastroenterology. 1997; 44: 467-471
        View in Article
        • Svoboda P.
        • Kantorová I.
        • Ochmann J.
        • et al.
        A prospective randomized controlled trial of sclerotherapy vs ligation in the prophylactic treatment of high-risk esophageal varices.
        Surg Endosc. 1999; 13: 580-584
        View in Article
        • Fukuda A.
        • Kajiyama T.
        • Arakawa H.
        • et al.
        Retroflexed endoscopic multiple band ligation of symptomatic internal hemorrhoids.
        Gastrointest Endosc. 2004; 59: 380-384
        View in Article
        • Ladep N.G.
        • Sule J.
        • Umar S.M.
        • et al.
        Oesophageal variceal band ligation using a saeed six-shooter multiband ligator; experience at Jos University Teaching Hospital, Nigeria: case report.
        Niger J Med. 2008; 17: 110-111
        View in Article

      Article info

      Publication history

      Published online: February 27, 2012

      Identification

      DOI: https://doi.org/10.1016/j.gie.2012.01.007

      Copyright

      © 2012 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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