Comparative evaluation of combined endoscopic variceal ligation (EVL) together with low volume endoscopic sclerotherapy (ES) versus sclerotherapy or band ligation alone for bleeding oesophageal varices

Khayat, H.R. El; Khamis, Abdelaziz

doi:10.1016/0016-5085(95)28547-4

Cited by 2 publications

(2 citation statements)

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“…For the outcome of esophageal variceal rebleeding, three of the eight trials did not specify whether rebleeding was due to esophageal varices, gastric varices, or posthemostasis ulcers (11,12,16). Therefore, data from those three trials were not included in the analysis.…”

Section: Study Selection and Data Collectionmentioning

confidence: 99%

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Combination Endoscopic Band Ligation and Sclerotherapy Compared with Endoscopic Band Ligation Alone for the Secondary Prophylaxis of Esophageal Variceal Hemorrhage: A Meta-Analysis

et al. 2005

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Endoscopic band ligation (EBL) is the community-accepted standard therapy for the secondary prophylaxis of esophageal variceal hemorrhage. Recent data indicate that combination EBL and sclerotherapy may be a more effective therapy than EBL alone. Yet existing data are conflicting. We therefore performed a meta-analysis to compare the efficacy and safety of EBL and sclerotherapy versus EBL alone for the secondary prophylaxis of esophageal variceal hemorrhage. We performed a systematic review of two computerized databases (MEDLINE and EMBASE) along with manual-searching of published abstracts to identify relevant citations without language restrictions from 1990 to 2002. Eight studies met explicit inclusion criteria. We performed meta-analysis of these studies to pool the relative risk for the following outcomes: esophageal variceal rebleeding, death, number of endoscopic sessions to achieve variceal obliteration, and therapeutic complications. There were no significant differences between EBL and sclerotherapy versus EBL alone in the risk of esophageal variceal rebleeding (RR = 1.05; 95% CI = 0.67-1.64; P = 0.83), death (RR = 0.99; 95% CI = 0.68-1.44; P = 0.96), or number of endoscopic sessions to variceal obliteration (RR = 0.23; 95% CI = 0.055-0.51; P = 0.11). However, the incidence of esophageal stricture formation was significantly higher in the EBL group than in the sclerotherapy group. There is no evidence that the addition of sclerotherapy to endoscopic band ligation changes clinically relevant outcomes (variceal rebleeding, death, time to variceal obliteration) in the secondary prophylaxis of esophageal variceal hemorrhage. Moreover, combination EBL and sclerotherapy had more esophageal stricture formation than EBL alone.

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Section: Study Selection and Data Collectionmentioning

confidence: 99%

“…However, subsequent randomized, controlled trials comparing EBL and sclerotherapy to EBL alone have reported conflicting results (9)(10)(11)(12)(13)(14)(15)(16). Due to the harmful consequences of variceal hemorrhage, it is essential to decide on an optimal endoscopic therapeutic modality based on the current available evidence.…”

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confidence: 99%