Endoscopic Treatment of Esophageal Varices: Kitano Method
A technique of endoscopic injection sclerotherapy (EIS) for esophageal varices, which Kitano et al. reported in 1987, consists of the use of an over-tube, a sclerosant of 5% ethanolamine oleate, and 1-week intervals between injections, with the EIS repeated until complete elimination of the lower esophageal mucosa. The technique was validated by several randomized controlled trials (RCTs) that were conducted by a portal hypertension group in the Department of Surgery II, Kyushu University. The results of 2105 cases showed that the cumulative nonbleeding rate was 90% at 15 years. This EIS technique was also compared with surgical procedures through another RCT and was equivalent to the surgical procedures in terms of nonbleeding and survival rates. In addition, the technique was also compared to endoscopic variceal ligation (EVL), and EVL significantly decreased the adverse effects associated with EIS. Although the EIS technique is now only performed in a limited number of institutions, it is safe, long-lasting, and established, and the achievement of favorable results remains excellent even now.
KeywordsEsophageal varices Endoscopic injection sclerotherapy Eradication Ethanolamine oleate
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