The Japanese journal of surgery

, Volume 17, Issue 4, pp 256–262 | Cite as

A transparent over-tube for endoscopic injection sclerotherapy and results in patients with esophageal varices

  • Seigo Kitano
  • Tetsuya Iwanaga
  • Yasunori Iso
  • Nobuhiro Koyanagi
  • Keizo Sugimachi
Original Articles


This report describes our data regarding repeated injection sclerotherapy using a newly designed over-tube. We treated 17 consecutive patients with esophageal varices, (3 acute, 6 elective and 8 prophylactic). An intravariceal injection of 5 per cent ethanolamine oleate was administered, using a newly designed transparent over-tube containing a second lumen for a flexible injection needle. This over-tube provides an easier, safer, shorter-in-time method of sclerosing esophageal varices. One of the 17 patients died as a result of liver failure associated with advanced cirrhosis and a concomitant hepatoma. Eradication of esophageal varices was attained in the remaining 16 patients, after an average of 5.0 injections over an average period of 5.8 weeks (range: 3–7 injections during 3–11 weeks). No complications, such as esophageal perforation or aspiration pneumonia were encountered. Recurrent variceal bleeding has not occurred during the 9 months follow-up.

Key Words

injection sclerotherapy esophageal varices doublelumened over-tube 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Crafoord C, Frenckner P. New surgical treatment of varices of veins of the esophagus. Acta Oto-laryng Stockh 1939; 27: 422–429.Google Scholar
  2. 2.
    Terblanche J, Northover JMA, Bornman P, Kahn D, Barbezat GO, Sellers SL, Saunders SJ. A prospective evaluation of injection sclerotherapy in the treatment of acute bleeding from esophageal varices. Surgery 1979; 85: 239–245.PubMedGoogle Scholar
  3. 3.
    Wodak E. Die Wandsklerosierung der Osophagus-schleimhaut im histologische Bild. Wien Med Wschr 1965; 115: 406–407.PubMedGoogle Scholar
  4. 4.
    Johnston GW, Rogers HW. Management of bleeding esophageal varices when portal systemic shunt is inadvisable, with particular reference to the use of balloon tamponade and sclerosing injections. Ulster Med J 1964; 33: 110–115.PubMedGoogle Scholar
  5. 5.
    Evans DMD, Jones DB, Clearly BK, Smith PH. Oesophageal varices treated by sclerotherapy. A histological study. Gut 1982; 23: 615–620.PubMedGoogle Scholar
  6. 6.
    Kitano S, Nagamine K, Iwanaga T, Beppu K, Koyanagi N, Iso Y, Sugimachi K. Eradication of esophageal varices with repeated injection sclerotherapy in inoperable patients. Gastroenterol Jpn 1986; 21: 1–5.PubMedGoogle Scholar
  7. 7.
    Rose JDR, Crane MD, Smith PM. Factors affecting successful endoscopic sclerotherapy for oesophageal varices. Gut 1983; 24: 946–949.PubMedGoogle Scholar
  8. 8.
    Takase Y, Ozaki A, Orii K, Nagoshi K, Okamura T, Iwatsuki Y. Injection sclerotherapy of esophageal varices for patients undergoing emergency and elective surgery. Surgery 1982; 92: 474–479.PubMedGoogle Scholar
  9. 9.
    Kitano S, Sugimachi K. A rapid, safer method of sclerosing esophageal varices—A new transparent tube—. Am J Surg 1987; 153: 317–319.PubMedCrossRefGoogle Scholar
  10. 10.
    Beppu K, Inokuchi K, Koyanagi N, Nakayama S, Sakata H, Kitano S, Kobayashi M. Prediction of variceal hemorrhage by esophageal endoscopy. Gastrointest Endosc 1981; 27: 213–218.PubMedGoogle Scholar
  11. 11.
    Hashizume M, Inokuchi K, Beppu K, Koyanagi N, Nagamine K, Sugimachi K, Hirose S. The natural history of non-alcoholic cirrhosis. 1984; 19: 430–435.Google Scholar
  12. 12.
    Terblanche J, Yakoob HI, Bornman PC, Stiegmann GV, Bane R, Jonker A, Wright J, Kirsch R. Acute bleeding varices. A five-year prospective evaluation of tamponade and sclerotherapy. Ann Surg 1981; 195: 521–530.CrossRefGoogle Scholar
  13. 13.
    Gryska PV, Hedberg SE. Injection thrombosclerosis of esophageal varices. Surg Gynecol Obstet 1985; 161: 438–444.Google Scholar
  14. 14.
    Soehendra N, deHeer K, Kempeneers I, Frommelt L. Morphological alterations of the esophagus after endoscopic sclerotherapy of varices. Endoscopy 1983; 15: 291–296.PubMedCrossRefGoogle Scholar

Copyright information

© The Japan Surgical Society 1987

Authors and Affiliations

  • Seigo Kitano
    • 1
  • Tetsuya Iwanaga
    • 1
  • Yasunori Iso
    • 1
  • Nobuhiro Koyanagi
    • 1
  • Keizo Sugimachi
    • 1
  1. 1.Department of Surgery IIKyushu University, Faculty of MedicineFukuokaJapan

Personalised recommendations