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The efficacy and safety of endoscopic ultrasound selective variceal devascularization for the treatment of esophagogastric varices: a retrospective cohort study.
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Guan Chengqi, Huang Fan, Shen Hongyuan, Huang Wei, Wang Yachen, Mao Zhenbiao, Lu Cuihua, Zhang Jian Feng
Аннотация
BACKGROUND: Gastroesophageal variceal bleeding is a life-threatening complication of portal hypertension. This study evaluated the efficacy and safety of endoscopic ultrasound-guided selective variceal devascularization (EUS-SVD) compared with conventional endoscopic cyanoacrylate injection.
METHODS: This retrospective cohort study adhered to the STROBE guidelines. Between August 2022 and June 2024, 107 patients were enrolled and allocated to conventional endoscopy (n = 52) or EUS-SVD (n = 55). Propensity score matching was performed to reduce confounding. Primary outcomes included rebleeding, ulcer formation, and resource utilization.
RESULTS: Compared with the conventional group, the EUS group required significantly lower volumes of polidocanol and cyanoacrylate (both P < 0.05). The 6‑month rebleeding rate and 3‑month ulcer formation rate were significantly lower in the EUS group (P < 0.05). Kaplan-Meier analysis demonstrated a reduced cumulative rebleeding incidence in the EUS group (HR 0.38, 95%CI 0.17-0.86, P = 0.021).
CONCLUSIONS: Within the limitations of a single-center retrospective design, these findings suggest that EUS-SVD may represent a promising therapeutic option for gastroesophageal varices, although it requires validation in prospective randomized trials.
METHODS: This retrospective cohort study adhered to the STROBE guidelines. Between August 2022 and June 2024, 107 patients were enrolled and allocated to conventional endoscopy (n = 52) or EUS-SVD (n = 55). Propensity score matching was performed to reduce confounding. Primary outcomes included rebleeding, ulcer formation, and resource utilization.
RESULTS: Compared with the conventional group, the EUS group required significantly lower volumes of polidocanol and cyanoacrylate (both P < 0.05). The 6‑month rebleeding rate and 3‑month ulcer formation rate were significantly lower in the EUS group (P < 0.05). Kaplan-Meier analysis demonstrated a reduced cumulative rebleeding incidence in the EUS group (HR 0.38, 95%CI 0.17-0.86, P = 0.021).
CONCLUSIONS: Within the limitations of a single-center retrospective design, these findings suggest that EUS-SVD may represent a promising therapeutic option for gastroesophageal varices, although it requires validation in prospective randomized trials.