[Prospective controlled study of para- and intravariceal sclerosing therapy of esophageal varices]

In a prospective randomized controlled clinical trial, prevention of hemorrhage from oesophageal varices by repeated peri- and intravariceal injections of 20 ml Aethoxysclerol 1% were compared with medical management alone. The study involved 126 patients with cirrhosis and recent variceal bleeding confirmed by endoscopy. Injection sclerotherapy was carried out using a fiberoptic gastroscope under 10-20 mg intravenous diazepam and 20 mg hyoscin -N-butyl-bromide. Injections were given at monthly intervals. During the first five sessions the agent was given by perivariceal injections followed by five sessions with intravariceal injections. After the 10 months of injection therapy the patients were followed up for 16 months. During the perivariceal injection period 37% of the patients in the sclerotherapy group had further bleeding compared with 39% of the control group. During intravariceal injections 12% of the sclerotherapy group and 38% of the control group had further bleeding (p less than 0.05). During the follow-up of 16 months after sclerotherapy, 16% of the sclerotherapy group and 56% of the control group had further bleeding (p less than 0.05), 35% of the sclerotherapy group and 61% of the control group died in these 26 months of investigation (p less than 0.05). Intravariceal injection sclerotherapy significantly decreased the incidence of further bleeding and mortality in patients with cirrhosis and oesophageal varices. Perivariceal injections did not appear to be effective.