Band ligation plus argon plasma for treatment and prevention recurrence of esophageal varices

• Grant number: 08/01031-9
• Support Opportunities: Regular Research Grants
• Start date: June 01, 2008
• End date: May 31, 2010
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Ademar Yamanaka
• Grantee: Ademar Yamanaka
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Esophageal variceal rupture hemorrhage is a common cause of death of cirrhotic patients. The best choice for prevention of rebleeding is endoscopic band ligation, a treatment that can reach variceal eradication. One of the problems of this method is that, after eradication, its common the development of new vessels, which can bleed if not treated. In this study it will be analyzed a technique that aim the reduction of variceal recurrence, the delivery of argon plasma in distal esophagus as soon as varices have been eradicated with band ligation. Argon coagulation can lead to fibrosis of deeper layers of esophageal wall, preventing development of new vessels. In a pilot study already published elsewhere with 16 patients, excellent results were obtained, with no recurrence after 16 months of follow-up and also no complications. The present study will be prospective and controlled. Patients with hepatic cirrhosis and previous episode of variceal bleeding will be randomized in two groups: in Group A they will treated with band ligation followed by argon plasma; in Group B will be treated with band ligation alone. After eradication, patients will be followed for at least one year to detect variceal recurrence. We expect that the patients of Group A have at least 20% less recurrence than Group B, without complications. (AU)