Prospective randomized trial comparing two injection techniques for sclerosing oesophageal varices: Over-tube and free-hand

Abstract

Abstract The safety, efficacy and complications of two techniques of endoscopic injection sclerotherapy were examined in 102 consecutive patients, using either a totally transparent over-tube or the free-hand technique. The choice of treatment was at random. There was a significantly higher control of variceal bleeding when the over-tube technique was used (100 per cent versus 77 per cent, P<0·05). The frequency of re-bleeding before the eradication of oesophageal varices was significantly less in the over-tube group than in the free-hand group (P<0·01), although all re-bleedings were well controlled with additional injections of 5 per cent ethanolamine oleate. There was no significant difference between the two techniques with regard to the frequency of endoscopic injection sclerotherapy for eradication of oesophageal varices. The over-tube technique is safer than the free-hand technique and takes less time to accomplish; at the initial session of treatment, time and bleeding during these techniques were 11·5 ± 2·3 mm (mean ± s.d.) and 7·3 ± 5·9 ml in the over-tube technique, and 20·4 ± 4·1 min and 45·1 ± 30·0 ml in the freehand technique (P<0·001, in both time and bleeding).