Endoscopic evaluation of the therapeutic effect of sclerotherapy for esophageal varices.

ABSTRACT

The rebleeding rate after endoscopic injection sclerotherapy was studied in 237 patients with esophageal varices, and the optimal outcome of treatment was determined. Two new categories, RC(2-) and F0, were added to the classification scheme of endoscopic findings of varices in Japan. RC(2-) represents a state in which no veins, not even small vessels, are observed by endoscopy after endoscopic injection sclerotherapy, and F0 represents a state in which no localized venous dilations in the esophagus exist. The criteria for defining the other categories were not altered, and the R-C sign was expressed as RC(2-), RC(-), or RC(+); the degree of dilation was classified as F0 to F3. By combining the R-C sign and the F number, endoscopic findings were classified 1 to 4 weeks after endoscopic injection sclerotherapy into groups designated RC(2-)F0, RC(-)F0, RC(-)F1, and RC(+)F1-RC(+)F2. The four groups were observed to determine the incidence of esophageal stricture and rebleeding. In the RC(2-)F0 group, the incidence of stricture was high, but the rebleeding rate was low. In the RC(-)F0 group, both the incidence of stricture and rebleeding rate were low. We conclude that the optimal outcome of endoscopic injection sclerotherapy is RC(-)F0.