Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2008-8-5
pubmed:abstractText
Both medical therapy and endoscopic variceal ligation (EVL) have proven to be comparable in the prevention of variceal rebleeding. However, the long-term results are still lacking. Our previous study enrolled 121 patients with history of esophageal variceal bleeding and randomized to receive EVL (EVL group, 60 patients) or drug therapy, nadolol plus isosorbide-5-mononitrate (N+I) (N+I group, 61 patients) to prevent variceal rebleeding. The EVL group received ligation regularly until variceal obliteration. The N+I group received N+I during the study period. Patients were followed for up to 8 years. After a median follow-up of 82 months, recurrent upper gastrointestinal bleeding developed in 28 patients (47%) in the EVL group and 49 patients (80%) in the N+I group (P = 0.001). Recurrent bleeding from esophageal varices occurred in 18 patients (30%) in the EVL group and 39 patients (64%) in the N+I group. The actuarial probability of rebleeding from esophageal varices was lower in the EVL group (P = 0.001). A total of 42 patients of the EVL group and 30 patients of the N+I group died (P = 0.013). The multivariate Cox analysis indicated that age, serum albumin, presence of encephalopathy, and treatment were the factors predictive of mortality. CONCLUSION: Our long-term follow-up study showed that combination of N+I therapy was inferior to banding ligation in the reduction of variceal rebleeding, but with enhanced survival.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Aug
pubmed:issn
1527-3350
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
48
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
580-7
pubmed:dateRevised
2011-7-15
pubmed:meshHeading
pubmed-meshheading:18666235-Adrenergic beta-Antagonists, pubmed-meshheading:18666235-Adult, pubmed-meshheading:18666235-Aged, pubmed-meshheading:18666235-Digestive System Surgical Procedures, pubmed-meshheading:18666235-Drug Therapy, Combination, pubmed-meshheading:18666235-Esophageal and Gastric Varices, pubmed-meshheading:18666235-Female, pubmed-meshheading:18666235-Follow-Up Studies, pubmed-meshheading:18666235-Gastrointestinal Hemorrhage, pubmed-meshheading:18666235-Humans, pubmed-meshheading:18666235-Isosorbide Dinitrate, pubmed-meshheading:18666235-Kaplan-Meier Estimate, pubmed-meshheading:18666235-Ligation, pubmed-meshheading:18666235-Male, pubmed-meshheading:18666235-Middle Aged, pubmed-meshheading:18666235-Nadolol, pubmed-meshheading:18666235-Recurrence, pubmed-meshheading:18666235-Treatment Outcome, pubmed-meshheading:18666235-Vasodilator Agents
pubmed:year
2008
pubmed:articleTitle
Improved survival in patients receiving medical therapy as compared with banding ligation for the prevention of esophageal variceal rebleeding.
pubmed:affiliation
Department of Medical Education and Research, Division of Gastroenterology, National Yang-Ming University, Taipei, Taiwan, Republic of China. ghlo@isca.vghks.gov.tw
pubmed:publicationType
Journal Article, Comparative Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't