Endoscopy international open · 2025
Endoscopic ultrasound-guided therapies versus retrograde transvenous obliteration for gastric varices: Multicenter propensity matched analysis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Giri Suprabhat, Patel Ranjan Kumar, Chavan Radhika, Shah Bhavik Bharat, Narayan Jimmy, Tripathy Taraprasad, Babbar Sushant, Garg Lalit, Gandhi Rozil, Anandpara Karan Manoj, Das Swati, Kanungo Manjit, Pati Girish Kumar, Nayak Hemanta K, Panigrahi Manas Kumar, Nath Preetam, Sahu Saroj Kanta, Praharaj Dibya Lochan, Mallick Bipadabhanjan, Panigrahi Sarat Chandra, Rajput Sanjay, Shah Jimil, Anand Anil Chandra, Sahu Manoj Kumar
Аннотация
BACKGROUND AND STUDY AIMS: Retrograde transvenous obliteration (RTO) is an established technique for managing fundal varices. Endoscopic ultrasound (EUS)-guided glue injection with or without coil is an alternate approach. The present study compared outcomes of EUS-guided therapies with RTO for managing fundal varices.
PATIENTS AND METHODS: We retrospectively analyzed data from patients with fundal varices undergoing EUS-guided intervention or RTO at 10 tertiary centers in India and compared after propensity score matching. The primary outcome was variceal bleeding within 1 year. Secondary outcomes included procedure-related adverse events (AEs), variceal obliteration, reintervention, and mortality.
RESULTS: A total of 167 patients (EUS 108, RTO 59) were included, with 59 in each group after propensity score matching. Incidence of variceal bleeding (15.3% vs. 13.6%, P = 0.793) within 1 year was comparable between the groups. Procedure-related AEs were higher in the RTO group (22% vs. 5.1%, P = 0.007), primarily new onset or worsening of ascites. Variceal obliteration at 4 weeks was similar between groups (83.1% vs. 91.5%, P = 0.167). Although reintervention within 1 year of the index procedure (30.5% vs. 22.0%, P = 0.296) was comparable, the EUS group required more frequent reintervention for GVs (28.8% vs. 5.1%, P = 0.001), and the RTO group required more frequent reintervention for EVs (16.9% vs. 1.7%, P = 0.008).
CONCLUSIONS: EUS-guided therapy offers a safe and effective alternative to RTO for managing fundal varices. Although reintervention rate for GVs were higher than for EUS, incidence of AEs and reintervention for EVs was higher with RTO.
PATIENTS AND METHODS: We retrospectively analyzed data from patients with fundal varices undergoing EUS-guided intervention or RTO at 10 tertiary centers in India and compared after propensity score matching. The primary outcome was variceal bleeding within 1 year. Secondary outcomes included procedure-related adverse events (AEs), variceal obliteration, reintervention, and mortality.
RESULTS: A total of 167 patients (EUS 108, RTO 59) were included, with 59 in each group after propensity score matching. Incidence of variceal bleeding (15.3% vs. 13.6%, P = 0.793) within 1 year was comparable between the groups. Procedure-related AEs were higher in the RTO group (22% vs. 5.1%, P = 0.007), primarily new onset or worsening of ascites. Variceal obliteration at 4 weeks was similar between groups (83.1% vs. 91.5%, P = 0.167). Although reintervention within 1 year of the index procedure (30.5% vs. 22.0%, P = 0.296) was comparable, the EUS group required more frequent reintervention for GVs (28.8% vs. 5.1%, P = 0.001), and the RTO group required more frequent reintervention for EVs (16.9% vs. 1.7%, P = 0.008).
CONCLUSIONS: EUS-guided therapy offers a safe and effective alternative to RTO for managing fundal varices. Although reintervention rate for GVs were higher than for EUS, incidence of AEs and reintervention for EVs was higher with RTO.