Summary
Endoscopic injection sclerotherapy (EIS) using the transparent overtube (OT) method can be conducted safely and easily not only in elective esophageal varices but also in emergency cases because of the ability to obtain a good field of view and fixation of the varix. However, application of the OT method is limited because intravariceal injection into small varices through the slit of the OT is impossible. We devised a technique to apply the OT method to small varices by utilizing negative pressure in the OT (np-OT method). By using negative pressure, EIS with a transparent overtube is now suitable for all grades of esophageal varices, and the accuracy of puncture in EIS has been improved. Injection of the target area was successful in all cases. The rate of intravariceal injection has also been improved (47% in low-grade varices) because injection of all sites was possible. We call EIS by the np-OT method “np-EIS”.
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References
Crafoord C, Frenckner P (1939) New surgical treatment of varicose veins of the oesophagus. Acta Otolaryngol 27: 422–429
Japanese Research Society for Portal Hypertension (1980) The general rules for recording endoscopic findings on esophageal varices. Jpn J Surg 10: 84–87
Johnston GW, Rodgers HW (1973) A review of 15 years' experience in the use of sclerotherapy in the control of acute haemorrhage from oesophageal varices. Br J Surg 60: 797–800
Kitano S, Sugimachi K (1987) A rapid and relatively safer method of sclerosing esophageal varices utilizing a new transparent tube. Am J Surg 153: 317–319
Kitano S, Nagamine K, Iwanaga T, Beppu K, Koyanagi N, Iso Y, Sugimachi K (1986) Eradication of esophageal varices with repeated injection sclerotherapy in inoperable patients. Gastroenterol Jpn 21: 1–5
Paquet KJ, Oberhammer E (1978) Sclerotherapy of bleeding esophageal varices by means of endoscopy. Endoscopy 10: 7–12
Raschke E, Paquet KJ (1973) Management of hemorrhage from esophageal varices using endoscopic method. Ann Surg 99: 177–181
Terblanche J, Northover JMA, Bornman P, Kahn D, Barbezat D, Sellars L, Saunders J (1979) A prospective evaluation of injection sclerotherapy in the treatment of acute bleeding from esophageal varices. Surgery 85: 239–245
Williams KGD, Dawson JL (1979) Fibreoptic injection of oesophageal varices. Br Med J 2: 766–767
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Kawano, T., Nakamura, H., Inoue, H. et al. Endoscopic injection sclerotherapy using a transparent overtube with intraluminal negative pressure (np-EIS) for esophageal varices. Surg Endosc 4, 15–17 (1990). https://doi.org/10.1007/BF00591405
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DOI: https://doi.org/10.1007/BF00591405