PDF(Pubmed)
Abstract：
BACKGROUND: Gastric variceal hemorrhage is one of the primary manifestations of left-sided portal hypertension (LSPH). The hemorrhage is fatal and requires safe and effective interventions.
OBJECTIVE: To evaluate the clinical safety and efficacy of modified endoscopic ultrasound (EUS)-guided selective N-butyl-2-cyanoacrylate (NBC) injections for gastric variceal hemorrhage in LSPH.
METHODS: A retrospective observational study of patients with LSPH-induced gastric variceal hemorrhage was conducted. Preoperative EUS evaluations were performed. Enrolled patients were divided into modified and conventional groups according to the NBC injection technique. The final selection of NBC injection technique depended on the patients\' preferences and clinical status. The technical and clinical success rates, operation time, NBC doses, perioperative complications, postoperative hospital stay, and recurrent bleeding rates were analyzed, respectively.
RESULTS: A total of 27 patients were enrolled. No statistically significant differences were observed between the two groups regarding baseline characteristics. In comparison to patients in the conventional group, patients in the modified group demonstrated significantly reduced NBC doses (2.0 ± 0.6 mL vs 3.1 ± 1.0 mL; P = 0.004) and increased endoscopic operation time (71.9 ± 11.9 min vs 22.5 ± 6.7 min; P < 0.001). Meanwhile, the two groups had no significant difference in the technical and clinical success rates, perioperative complications, postoperative hospital stay, and recurrent bleeding rates.
CONCLUSIONS: Modified EUS-guided selective NBC injections demonstrated safety and efficacy for LSPH-induced gastric variceal hemorrhage, with advantages of reduced injection dose and no radiation risk. Drawbacks were time consumption and technical challenge.
OBJECTIVE: To evaluate the clinical safety and efficacy of modified endoscopic ultrasound (EUS)-guided selective N-butyl-2-cyanoacrylate (NBC) injections for gastric variceal hemorrhage in LSPH.
METHODS: A retrospective observational study of patients with LSPH-induced gastric variceal hemorrhage was conducted. Preoperative EUS evaluations were performed. Enrolled patients were divided into modified and conventional groups according to the NBC injection technique. The final selection of NBC injection technique depended on the patients\' preferences and clinical status. The technical and clinical success rates, operation time, NBC doses, perioperative complications, postoperative hospital stay, and recurrent bleeding rates were analyzed, respectively.
RESULTS: A total of 27 patients were enrolled. No statistically significant differences were observed between the two groups regarding baseline characteristics. In comparison to patients in the conventional group, patients in the modified group demonstrated significantly reduced NBC doses (2.0 ± 0.6 mL vs 3.1 ± 1.0 mL; P = 0.004) and increased endoscopic operation time (71.9 ± 11.9 min vs 22.5 ± 6.7 min; P < 0.001). Meanwhile, the two groups had no significant difference in the technical and clinical success rates, perioperative complications, postoperative hospital stay, and recurrent bleeding rates.
CONCLUSIONS: Modified EUS-guided selective NBC injections demonstrated safety and efficacy for LSPH-induced gastric variceal hemorrhage, with advantages of reduced injection dose and no radiation risk. Drawbacks were time consumption and technical challenge.
摘要：
背景：胃静脉曲张破裂出血是左侧门静脉高压症（LSPH）的主要表现之一。出血是致命的，需要安全有效的干预措施。
目的：评估改良内镜超声（EUS）引导的选择性N-丁基-2-氰基丙烯酸酯（NBC）注射治疗LSPH胃底静脉曲张出血的临床安全性和有效性。
方法：对LSPH致胃底静脉曲张破裂出血患者进行回顾性观察研究。进行了术前EUS评估。根据NBC注射技术将注册患者分为改良组和常规组。NBC注射技术的最终选择取决于患者的偏好和临床状况。技术和临床成功率，操作时间,NBC剂量，围手术期并发症,术后住院时间,并分析了再出血率，分别。
结果：共纳入27例患者。两组之间在基线特征方面没有观察到统计学上的显着差异。与常规组患者相比,改良组患者的NBC剂量显著减少(2.0±0.6mLvs3.1±1.0mL;P=0.004),内镜手术时间增加(71.9±11.9minvs22.5±6.7min;P<0.001).同时,两组在技术和临床成功率上无显著差异,围手术期并发症,术后住院时间,和复发性出血率。
结论：改良EUS引导的选择性NBC注射证明了LSPH引起的胃底静脉曲张出血的安全性和有效性，具有减少注射剂量和无辐射风险的优点。缺点是时间消耗和技术挑战。
目的：评估改良内镜超声（EUS）引导的选择性N-丁基-2-氰基丙烯酸酯（NBC）注射治疗LSPH胃底静脉曲张出血的临床安全性和有效性。
方法：对LSPH致胃底静脉曲张破裂出血患者进行回顾性观察研究。进行了术前EUS评估。根据NBC注射技术将注册患者分为改良组和常规组。NBC注射技术的最终选择取决于患者的偏好和临床状况。技术和临床成功率，操作时间,NBC剂量，围手术期并发症,术后住院时间,并分析了再出血率，分别。
结果：共纳入27例患者。两组之间在基线特征方面没有观察到统计学上的显着差异。与常规组患者相比,改良组患者的NBC剂量显著减少(2.0±0.6mLvs3.1±1.0mL;P=0.004),内镜手术时间增加(71.9±11.9minvs22.5±6.7min;P<0.001).同时,两组在技术和临床成功率上无显著差异,围手术期并发症,术后住院时间,和复发性出血率。
结论：改良EUS引导的选择性NBC注射证明了LSPH引起的胃底静脉曲张出血的安全性和有效性，具有减少注射剂量和无辐射风险的优点。缺点是时间消耗和技术挑战。
