Role of EUS evaluation after endoscopic eradication of esophageal varices with band ligation
Carregando...
Citações na Scopus
22
Tipo de produção
article
Data de publicação
2016
Título da Revista
ISSN da Revista
Título do Volume
Editora
MOSBY-ELSEVIER
Citação
GASTROINTESTINAL ENDOSCOPY, v.84, n.3, p.400-407, 2016
Resumo
Background and Aims: Variceal recurrence after endoscopic band ligation (EBL) for secondary prophylaxis is a frequent event. Some studies have reported a correlation between variceal recurrence and variceal rebleeding with the EUS features of paraesophageal vessels. A prospective observational study was conducted to correlate EUS evaluation of paraesophageal varices, azygos vein, and thoracic duct with variceal recurrence after EBL variceal eradication in patients with cirrhosis. Methods: EUS was performed before and 1 month after EBL variceal eradication. Paraesophageal varices, azygos vein, and thoracic duct maximum diameters were evaluated in predetermined anatomic stations. After EBL variceal eradication, patients were submitted to endoscopic examinations every 3 months for 1 year. We looked for EUS features that could predict variceal recurrence. Results: Thirty patients completed a 1-year endoscopic follow-up. Seventeen patients (57%) presented variceal recurrence. There was no correlation between azygos vein and thoracic duct diameter with variceal recurrence. Larger paraesophageal varices predicted variceal recurrence in both evaluation periods. Paraesophageal varices diameters that best correlated with variceal recurrence were 6.3 mm before EBL (52.9% sensitivity, 92.3% specificity, and .749 area under the receiver operating characteristic curve [AUROC]) and 4 mm after EBL (70.6% sensitivity, 84.6% specificity, and .801 AUROC). Conclusions: We conclude that paraesophageal varices diameter measured by EUS predicts variceal recurrence within 1 year after EBL variceal eradication. Paraesophageal diameter after variceal eradication is a better recurrence predictor, because it has a lower cut-off parameter, higher sensitivity, and higher AUROC.
Palavras-chave
Referências
- Baroncini D, 1997, ENDOSCOPY, V29, P235
- Bosch J, 2003, LANCET, V361, P952, DOI 10.1016/S0140-6736(03)12778-X
- Caletti G, 1997, GASTROINTEST ENDOSC, V45, P332
- CALETTI GC, 1991, ENDOSCOPY, V23, P284, DOI 10.1055/s-2007-1010688
- Garcia-Pagan JC, 2010, NEW ENGL J MED, V362, P2370, DOI 10.1056/NEJMoa0910102
- de Franchis R, 2015, J HEPATOL, V63, P743, DOI 10.1016/j.jhep.2015.05.022
- de Paulo GA, 2006, GASTROINTEST ENDOSC, V63, P396, DOI 10.1016/j.gie.2005.10.039
- Faigel DO, 2000, GASTROINTEST ENDOSC, V52, P455, DOI 10.1067/mge.2000.107297
- Harewood GC, 2006, J GASTROEN HEPATOL, V21, P237, DOI 10.1111/j.1440-1746.2006.04169.x
- Hou MC, 2000, J HEPATOL, V32, P202, DOI 10.1016/S0168-8278(00)80064-1
- Irisawa A, 2001, GASTROINTEST ENDOSC, V53, P77, DOI 10.1067/mge.2001.108479
- Kakutani H, 2005, HEPATOL RES, V33, P259, DOI 10.1016/j.hepres.2005.09.003
- Karsan HA, 2005, DIGEST DIS SCI, V50, P399, DOI 10.1007/s10620-005-1618-9
- Kassem AM, 2000, ENDOSCOPY, V32, P630
- Konishi Y, 2002, GASTROINTEST ENDOSC, V55, P197, DOI 10.1067/mge.2002.121338
- Kume K, 2011, HEPATO-GASTROENTEROL, V58, P798
- Leung VKS, 1997, GASTROENTEROLOGY, V112, P1811, DOI 10.1053/gast.1997.v112.pm9178670
- Lo GH, 1999, GASTROINTEST ENDOSC, V49, P428, DOI 10.1016/S0016-5107(99)70038-6
- Lo GH, 2010, CLIN LIVER DIS, V14, P307, DOI 10.1016/j.cld.2010.03.009
- Lucey MR, 2008, AM J GASTROENTEROL, V103, P1698, DOI 10.1111/j.1572-0241.2008.01837.x
- Nakamura S, 2001, GASTROINTEST ENDOSC, V53, pAB140
- Ouakaa-Kchaou A, 2011, SAUDI J GASTROENTERO, V17, P105, DOI 10.4103/1319-3767.77238
- Garcia Pagan JC, 2008, ALIMENT PHARM THER, V28, P178
- PALMER ED, 1956, GASTROENTEROLOGY, V30, P85
- R CoRE TEAM, 2015, LANG ENV STAT COMP
- Sarin SK, 1999, NEW ENGL J MED, V340, P988, DOI 10.1056/NEJM199904013401302
- Sarin SK, 1997, J HEPATOL, V26, P826, DOI 10.1016/S0168-8278(97)80248-6
- Schmitz RJ, 2001, AM J GASTROENTEROL, V96, P437
- Suzuki T, 2000, GASTROINTEST ENDOSC, V52, P611, DOI 10.1067/mge.2000.109801
- Tait IS, 1999, BRIT J SURG, V86, P437
- Garcia Tsao G, 2007, HEPATOLOGY, V46, P922
- Garcia Tsao G, 2001, GASTROENTEROLOGY, V120, P726