Summary
Sixty-three patients with degree III or IV esophageal varices and the so-called red
color sign, but without previous bleeding were randomly assigned to either prophylactic
sclerotherapy (PST) (n = 30) or to a control group (n = 33). In 58 cases the portal
hypertension was caused by liver cirrhosis (40 % alcoholics). The two groups were
comparable with respect to demographic data and endoscopic appearance, causes and
severity of liver damage. Sclerotherapy was performed as combined intra- and paravariceal
injections of 2 or 3 % polidocanol. All patients, both in the treatment and in the
control groups, who bled from varices after randomization, received sclerotherapy
until the varices were eradicated, and remained in their groups. After a mean follow-up
of 44.5 months, the bleeding rate in the PST group was significantly lower (30 % vs
75 %; p < 0.01). The difference became significant from the second year onward. Fourteen
patients of the PST group and 19 of the controls died (4 and 14, respectively, p < 0.05
as a result of the bleeding). Life table analysis (Kaplan-Meier) revealed no differences
in survival between the two groups. At the present time PST cannot yet be recommended
as a method for clinical routine use.
Key words:
Esophageal varices - Prophylactic endoscopic sclerotherapy - Esophageal variceal hemorrhage
