Usefulness of Transnasal Argon Plasma Coagulation for Esophageal Varices Compared with the Peroral Method: A Randomized and Prospective Clinical Study
| العنوان: | Usefulness of Transnasal Argon Plasma Coagulation for Esophageal Varices Compared with the Peroral Method: A Randomized and Prospective Clinical Study |
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| المؤلفون: | Shigeki Ichimura, Takatomo Sano, Katsutoshi Sugimoto, Yasuharu Imai, Fuminori Moriyasu, Eigaku Murashima, Takashi Kawai, Ikuo Nakamura, Junichi Taira, Yoshihiro Furuichi, Yuki Miyata |
| المصدر: | Digestion. 87:17-22 |
| بيانات النشر: | S. Karger AG, 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Liver Cirrhosis, Male, medicine.medical_specialty, genetic structures, medicine.medical_treatment, Conscious Sedation, Argon plasma coagulation, Esophageal and Gastric Varices, law.invention, Esophageal varices, Randomized controlled trial, Recurrence, law, Sclerotherapy, Humans, Medicine, Prospective Studies, Prospective cohort study, Aged, Argon Plasma Coagulation, medicine.diagnostic_test, business.industry, Gastroenterology, Endoscopy, Middle Aged, medicine.disease, eye diseases, Clinical trial, Hepatic Encephalopathy, Female, sense organs, Radiology, business, Varices |
| الوصف: | Background: Argon plasma coagulation (APC) is very useful as a consolidation treatment for reducing the recurrence of esophageal varices (EVs). However, repeated sedation in endoscopic treatment has the risk of prolonging hepatic encephalopathy and affects the respiratory state of liver cirrhosis (LC) patients, in whom pulmonary arteriovenous shunts are observed. We evaluated prospectively whether transnasal endoscopic APC without sedation is more effective than peroral endoscopic APC with sedation. Patients and Methods: LC patients (n = 101), treated by endoscopic injection sclerotherapy to eradicate EVs, were randomly divided into a transnasal APC group (n = 50) and a peroral APC group (n = 51). The primary efficacy endpoint was the cumulative recurrence rate of EVs. The secondary endpoints were blood pressure (BP), heart rate, oxygen saturation during APC and complications. Results: There was no significant difference in the cumulative recurrence rate of EVs at 36 months between the transnasal APC and peroral APC groups (35.0 vs. 40.8%, p = 0.39, log-rank test), indicating that transnasal APC is not inferior to peroral APC. The transnasal APC group showed more stable intraoperative BP and oxygen saturation values, and a lower incidence of epigastralgia (56.0 vs. 74.5%, p = 0.04). Conclusion: The efficacy of reducing the recurrence of EVs in the transnasal APC group was not significantly different from that in the peroral APC group. Transnasal APC caused less distress and required no sedation. Therefore, this method was more advantageous for LC patients at risk of suffering from prolongation of hepatic encephalopathy. |
| تدمد: | 1421-9867 0012-2823 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0737ef1363a98e0d695d8e074cbf3a8d https://doi.org/10.1159/000343901 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....0737ef1363a98e0d695d8e074cbf3a8d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14219867 00122823 |
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