Korean Journal of Gastrointestinal Endoscopy 2000;20(4): 245-253.
식도정맥류에 있어서 새로운 소형 박리성계제 결찰용범 ( Mini-detachable snare ligation ) 의 임상적 유용성 ( Clinical Usefulness of the Newly Designed Mini-Detachable Snare Ligation on Esophageal Varices )
이문성(Moon Sung Lee),심찬섭(Chan Sup Shim),홍수진(Su Jin Hong),김진오(Jin Oh Kim),조주영(Joo Young Cho),이준성(Joon Seong Lee)
Abstract
Background/Aims : At present, various methods of endoscopic esophageal variceal treatment have been developed. But a superlative method has yet not been developed for endoscopic esophageal variceal treatment. For overcoming various disadvantages of endoscopic esophageal variceal treatment. We manufactured and reported the usefulness of a newly designed mini-detachable snare (stainless steel) in the treatment of esophageal varices. Method : In this randomized trial, we performed mini-detachable snare ligation (MDL) on 46 patients who had esophageal varices and we compared the results with the group of multiple band ligation (MBL) performed on 57 patients in the aspects of urgent hemostatic rate, rebleeding rate, eradication rate and recurrence rate etc. from March, 1997 to present. Results: 6 of 7 patients (86%) in mini-detachable snare ligation group and 11 of 13 patients (85%) in multiple band ligation group were successfully controlled by urgent hemostasis. Rebleeding following initiation occured in 2 (5.5%) in MDL group and 3 (5.3%) in MBL group. Esophageal varices were eradicated or reduced to grade I in 96% and 98% by 2-7 snares and 3-10 ligation/one session in 3-9 and 3-8 session (mean+ SD: 4.8±2.1 and 4.5±1.9 session) in the MDL group and MBL group respectively. The recurrence rate was 5 (11%) and 6 (11%) in MDL group and MBL group respectively during 6 to 16 months follow up period. The mean procedure time taken during 5 snares or 5 bands was 4.07±3.8 min and 3.23±1.2 min in MDL group and MBL group respectively. No serious complications occurred in both groups. Conclusions : The mini-detachable snare ligation may be considered as a new and relatively safe, and effective therapeutic modality in the treatment for esophageal varices, Also the mini-detachable snare system is much cheaper than other multi-fire ligation devices but further clinical evaluation and more technical improvements in mini-detachable snare ligation will be needed. (Korean J Gastrointest Endosc 2000;20:245-253)
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