EFFICIENCY AND SAFETY OF ESOPHAGEAL BAND LIGATION AND SCLEROTHERAPY IN CHILDREN WITH ESOPHAGEAL VARICES
Makaleler > Tam Makale · 2006
Yazarlar: Sema AYDOĞDU, G Tumgor, H.A Yuksekkaya, M Cakir, C Arikan, M Baran, Funda ÇETİN, R.V Yagci
Journal of Pediatric Gastroenterology and Nutrition, Uluslararası, Wos, 2006, cilt 42
DOI: 10.1002/j.1536-4801.2006.tb01821.x
Özet
The aim of this study is to compare the efficiency and safety of esophageal band ligation and sclerotherapy in children with esophageal varices Between January 1996-November 2005, patients with esophageal varices by endoscopy in Ege University Department of Pediatric Gastroenterology, Hepatology and Nutrition were evaluated retrospectively (Mean age 9.9 (1.5-18), M/F 54/59) (Table 1). 409 upper gastrointestinal system endoscopy were performed in these cases. Varices were graded on the scale based on Conn's criteria. Prophylactic propranolol was started in all patients (0.5-2 mg/kg; twice a day, max. 125 mg). Cases, to whom both esophageal band ligation and sclerotherapy were performed, were excluded from study. 191 sclerotherapy were performed to 37 cases (mean op; 5.1 (1-24 op)), 77 band ligation were performed to 25 cases (mean op; 3,0 (1-9)), both sclerotherapy and band ligation were performed in different times to 4 cases. Mean follow-up times of cases having sclerotherapy and band ligation were respectively 5.7 and 2.4. 12 cases applied for varices bleeding (%9.8), 6 of them sclerotherapy (50%), 5 of them band ligation (41.6%), and once both band ligation and sclerotherapy in different times (seconder prophylaxis) were applied. The mean age (range) of the patients with sclerotherapy (14 M, 23 F) and band ligation (12M, 13F) were 9.8 years (2.5-16 years) and 9.9 years (1.5-18 years), respectively. The youngest child treated with band ligation was 1.5 years old and 9 kg, and the youngest child treated with sclerotherapy was 2.5 years old and 11 kg. Complication was observed in 12 (32.4%) of the 37 patients with sclerotherapy; 9 were esophagitis and three ulcers. On the other hand, only one patient (4%) had complication during the band ligation due to intervention. Rebleeding was observed in three (12%) of 37 cases with band ligation and in five (13%) of 37 sclerotherapy (p > 0.05). No bleeding was observed in seconder prophylaxis performed group. It is observed that, band ligation is more effective then sclerotherapy in the treatment of upper gastrointestinal bleeding.