Abstract：
First, it has been demonstrated that endoscopic ultrasonography (EUS)-guided cyanoacrylate (CYA) injection (EUS-CYA) has greater efficacy than direct endoscopic injection of cyanoacrylate (DEI-CYA) for treating type 1-isolated gastric varices. However, it is necessary to conduct further studies to determine whether EUS has any advantage over the current guidelines for treating gastroesophageal varices type 1 (GOV1). Second, liver function is an important prognostic factor in patients with liver cirrhosis. Therefore, we evaluated the liver function of patients treated with EUS-CYA.
In a single-center study, a prospective cohort from February 2021 to September 2022 involving 89 patients with cirrhosis with GOV1 were assigned to undergo EUS-CYA (n = 45) or DEI-CYA (n = 44). The success rate of CYA injection, the rate of overall rebleeding, the rate of reintervention, the complications during the follow-up period, and the liver function were compared.
In both groups, 100% of the operations were successful. The follow-up time of the two groups was 290 (153-398) days and 267 (177-416) days, respectively. In the EUS group, the perforating veins had an average diameter of 7.0 ± 2.7 mm, and they had a 100% occlusion rate. A statistically significant difference was found between the two groups regarding the number of sessions needed to eradicate GV (p = 0.005, pairwise comparisons were conducted using the Bonferroni correction method.), the late rebleeding rate after EUS-CYA [n = 3 (6.7%) vs n = 10 (22.7%); p = 0.032], and the incidence of postinjection ulcers [n = 4 (8.9%) vs n = 12 (27.3); p = 0.023)]. Following EUS or DEI-CYA treatment, the patient\'s liver function did not show any significant deterioration or decline.
EUS-CYA has a higher eradication success rate and fewer complications, recurrences, and rebleeding episodes than DEI-CYA used for GOV1 treatment. In addition, EUS-CYA did not impair liver function.
In a single-center study, a prospective cohort from February 2021 to September 2022 involving 89 patients with cirrhosis with GOV1 were assigned to undergo EUS-CYA (n = 45) or DEI-CYA (n = 44). The success rate of CYA injection, the rate of overall rebleeding, the rate of reintervention, the complications during the follow-up period, and the liver function were compared.
In both groups, 100% of the operations were successful. The follow-up time of the two groups was 290 (153-398) days and 267 (177-416) days, respectively. In the EUS group, the perforating veins had an average diameter of 7.0 ± 2.7 mm, and they had a 100% occlusion rate. A statistically significant difference was found between the two groups regarding the number of sessions needed to eradicate GV (p = 0.005, pairwise comparisons were conducted using the Bonferroni correction method.), the late rebleeding rate after EUS-CYA [n = 3 (6.7%) vs n = 10 (22.7%); p = 0.032], and the incidence of postinjection ulcers [n = 4 (8.9%) vs n = 12 (27.3); p = 0.023)]. Following EUS or DEI-CYA treatment, the patient\'s liver function did not show any significant deterioration or decline.
EUS-CYA has a higher eradication success rate and fewer complications, recurrences, and rebleeding episodes than DEI-CYA used for GOV1 treatment. In addition, EUS-CYA did not impair liver function.
摘要：
目标：首先，已经证明，内镜超声（EUS）引导的氰基丙烯酸酯（CYA）注射（EUS-CYA）比直接内镜注射氰基丙烯酸酯（DEI-CYA）治疗1型孤立性胃底静脉曲张的疗效更高。然而,有必要进行进一步的研究,以确定EUS是否比目前治疗1型胃食管静脉曲张(GOV1)的指南有任何优势.第二,肝功能是影响肝硬化患者预后的重要因素。因此,我们评估了接受EUS-CYA治疗的患者的肝功能。
方法：在单中心研究中，2021年2月至2022年9月的一项前瞻性队列研究包括89例患有GOV1的肝硬化患者,被分配接受EUS-CYA(n=45)或DEI-CYA(n=44).CYA注射成功率,总体再出血率，再干预率，随访期间的并发症，并对肝功能进行比较。
结果：在两组中，100%的手术都是成功的。两组随访时间分别为290(153-398)天和267(177-416)天,分别。在EUS组中,穿通静脉的平均直径为7.0±2.7毫米，他们有100%的闭塞率。在根除GV所需的疗程数量方面，两组之间存在统计学上的显着差异（p=0.005，使用Bonferroni校正方法进行了成对比较。),EUS-CYA后的晚期再出血率[n=3（6.7％）vsn=10（22.7％）；p=0.032]，和注射后溃疡的发生率[n=4（8.9％）vsn=12（27.3）；p=0.023]。EUS或DEI-CYA治疗后，患者的肝功能没有明显恶化或下降。
结论：EUS-CYA具有较高的根除成功率和较少的并发症，复发，与用于GOV1治疗的DEI-CYA相比，再出血发作。此外,EUS-CYA未损害肝功能。
方法：在单中心研究中，2021年2月至2022年9月的一项前瞻性队列研究包括89例患有GOV1的肝硬化患者,被分配接受EUS-CYA(n=45)或DEI-CYA(n=44).CYA注射成功率,总体再出血率，再干预率，随访期间的并发症，并对肝功能进行比较。
结果：在两组中，100%的手术都是成功的。两组随访时间分别为290(153-398)天和267(177-416)天,分别。在EUS组中,穿通静脉的平均直径为7.0±2.7毫米，他们有100%的闭塞率。在根除GV所需的疗程数量方面，两组之间存在统计学上的显着差异（p=0.005，使用Bonferroni校正方法进行了成对比较。),EUS-CYA后的晚期再出血率[n=3（6.7％）vsn=10（22.7％）；p=0.032]，和注射后溃疡的发生率[n=4（8.9％）vsn=12（27.3）；p=0.023]。EUS或DEI-CYA治疗后，患者的肝功能没有明显恶化或下降。
结论：EUS-CYA具有较高的根除成功率和较少的并发症，复发，与用于GOV1治疗的DEI-CYA相比，再出血发作。此外,EUS-CYA未损害肝功能。
