Is sclerotherapy the first choice treatment for active oesophageal variceal bleeding in cirrhotic patients? Final report of a randomized controlled trial

Alexandrino, Paula; Alves, M. Martins; Fidalgo, Paulo; Matos, Luís Costa; Esteves, Afonso; Veloso, José Artur de Paiva; Oliveira, Alexandre G.; Moura, Marta Carneiro de

doi:10.1016/0168-8278(90)91337-v

Cited by 19 publications

(6 citation statements)

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“…In comparison with no active treatment, the pooled results of four randomised trials72-75 showed that it reduced failure to control variceal bleeding although mortality was unaffected. Trials comparing sclerotherapy with vasopressin76-79 have shown no significant effect on reduction in the failure to control the variceal bleed, except in one study78 where rebleeding was significantly lower in patients treated with sclerotherapy.…”

Section: 0 Management Of Active Variceal Haemorrhagementioning

confidence: 98%

UK guidelines on the management of variceal haemorrhage in cirrhotic patients

Jalan

Hayes²

2000

Gut

177

164

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Section: 0 Management Of Active Variceal Haemorrhagementioning

confidence: 98%

UK guidelines on the management of variceal haemorrhage in cirrhotic patients

Jalan

Hayes²

2000

Gut

177

164

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“…Group A: sclerotherapy combined with vasoactive agents/bal− loon tamponade vs. vasoactive agents/balloon tamponade The five trials [12 ± 16] in this group included three papers [13,15,16] and two abstracts [12,14], and involved 413 episodes in 400 patients (see Tables e1 and e2).…”

Section: Descriptive Assessmentmentioning

confidence: 99%

An evaluation of emergency sclerotherapy of varices in randomized trials: looking the needle in the eye

et al. 2006

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This comparison of sclerotherapy across trials demonstrates a problem in defining its real efficacy. The conclusive evidence for substituting banding ligation or the combination of vasoconstrictors with sclerotherapy as better therapeutic approaches has not been provided in randomized trials. Sclerotherapy can remain a gold standard in variceal bleeding but there is scope for further studies of ligation and vasoactive drugs.

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“…Clearly, in both these circumstances control of bleeding before endoscopy and sclerotherapy has obvious clin ical benefits. Alexandrino et al 1990 (5) 71"r 71% Denote5 a significant difference between treatments.…”

Section: Drawbacksmentioning

confidence: 94%

Somatostatin: An Alternative to Sclerotherapy?

Baxter

Jenkins

1994

Scandinavian Journal of Gastroenterology

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Somatostatin: an alternative to sclerotherapy? Scand J Gastroenterol 1994;29 Background: The mortality rate of bleeding from oesophageal varices (30-40%) makes it one of the most serious emergencies today. Since in 30-40% of patients varices are actively bleeding, urgent control is mandatory for preventing the patient from dying of hypovolaemic shock. Analysis of the different rnefhods: Various reports have shown the efficacy of injection sclerotherapy, one session controlling bleeding in 75-80% of patients, and a second increasing the success rate to 90-95%. However, the facilities for 24-h endoscopy and the expertise are not always available in the hospital. Therefore, there is a need for an effective stop-gap therapy for controlling variceal bleeding until definitive therapy can be carried out. Comparisons of various drugs have provided conflicting results. It is not clear whether combined vasopressin and nitroglycerin is superior to injection sclerotherapy in the acute control of variceal haemorrhage. A randomized controlled trial has showed somatostatin to be as effective as injection therapy in the control of acute variceal bleeding and incidence of recurrent bleeding in the first 5 days after initiation of therapy. Conclusion: Somatostatin is a safe and effective treatment for the control of acute variceal haemorrhage and for preventing early rebleeding.

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Is sclerotherapy the first choice treatment for active oesophageal variceal bleeding in cirrhotic patients? Final report of a randomized controlled trial

Cited by 19 publications

References 0 publications

UK guidelines on the management of variceal haemorrhage in cirrhotic patients

UK guidelines on the management of variceal haemorrhage in cirrhotic patients

An evaluation of emergency sclerotherapy of varices in randomized trials: looking the needle in the eye

Somatostatin: An Alternative to Sclerotherapy?

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