PubMed · 1046361
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D T McCarty. 1976. Esophagus replacement.. https://doi.org/10.1016/s0001-2092(07)70293-4
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From November 1985 to February 1991, sixty patients were randomized to three groups of intravariceal sclerotherapy: (1) many punctures of low quantity sclerosant, (2) one puncture of large quantity sclerosant, and (3) one puncture of large quantity sclerosant with transendoscopic balloon. The early effects and complications were investigated. Varices eradication was reached 91.2% in group 1, significantly higher than group 2 (58.3%) (P < 0.05), similar to group 3(89.9%). However, balloon group (group 3) required shorter duration than group 1 (12.6 vs. 21.7 days) (P < 0.05). There were no significant differences in complications, but all 6 esophageal stenosis were in group 1, recurrent bleeding was 11.4% in group 1.35.7% in group 2 and 0 in group 3 during sclerotherapy sessions. Further more, we found though attempted to inject into variceal veins, accurate intravariceal injection reached only 46.8% in accordance with venographic findings. We conclude that sclerotherapy with transendoscopic balloon seems to be more simple, safer, and required short time to produce successful variceal sclerosis.
Surgical treatment of peptic stricture of the esophagus associated with columnar (Barrett) metaplasia can be a difficult problem. Collis-Nissen fundoplication restores an intraabdominal antireflux barrier for most cases of peptic stricture; however, 20% of patients may have persistence of pathological acid reflux. By reducing acidity of postoperative reflux, parietal cell vagotomy may complement nonresectional surgical results for Barrett stricture.