Akut Özofagus Varis Kanama Tedavisinde Endoskopik Band Ligasyonunun Etkinliği

Amaç: Özofagus varis kanama tedavisinde endoskopik band ligasyonunun (EBL) yeniden kanama ve mortalite üzerine etkiliğini belirlemek. Yöntemler: 2018-2020 yılları arasında acil servise akut özofagus varis kanaması ile başvuran ve ilk 12 saat içerisinde EBL tedavisi uygulanan 50 siroz hastası retrospektif olarak değerlendirildi. Bulgular: Hastaların 27’si (%54) erkek, 23’ü (%46) kadındı. Hastaların ortalama hastanede yatış süresi 6,45,6 gün, ortalama kan transfüzyon ihtiyacı 3,62,7 ünite idi. Beş (%10) hastada 30 gün içinde, 7(%14) hastada 1 yıl içinde tekrar kanama görüldü. On (%20) hasta 30 gün içinde, 11 (%22) hasta 1 yıl içinde öldü. Grade 3 varisli hastalarda (4,93,1) grade 2 varisli hastalara (2,51,5) göre kan transfüzyon ihtiyacı daha fazla idi(p=0,001). 30 gün ve 1 yıl içinde ölüm oranı grade 3 varisli hastalarda anlamlı olarak daha yüksekti (p=0,001). Otuz gün ve 1 yıl içinde kanama görülme oranı grade 3 varisli hastalarda grade 2 varisli hastalara göre daha yüksek olmakla birlikte fark anlamlı değildi (p=0,087). Sonuç: Akut özofagus varis kanama hastalarında EBL, tekrar kanama riskinin ve mortalite oranının az olması nedeniyle tercih edilecek bir endoskopik tedavi yöntemidir.

Anahtar Kelimeler:

siroz, endoskopik bant ligasyonu (EBL), özefagus varis kanaması

Efficacy of Endoscopic Band Ligation in the Treatment of Acute Esophageal Varicose Bleeding

Objective: To determine the efficacy of endoscopic band ligation (EBL) on rebleeding and mortality in the treatment of esophageal varices bleeding. Methods: Fifty cirrhosis patients who applied to the emergency department with acute esophageal variceal bleeding between 2018 and 2020 and were treated with EBL within the first 12 hours were evaluated retrospectively. Results: Twenty-seven (54%) patients were male and 23 (46%) were female. The mean hospital stay of the patients was 6.45.6 days, and the mean blood transfusion requirement was 3.62.7 units. Re-bleeding was observed within 30 days in 5 (10%) patients and within 1 year in 7 (14%) patients. Ten (20%) patients died within 30 days, and 11 (22%) patients died within 1 year. The need for blood transfusion was higher in patients with grade 3 varicose veins (4.93.1) than in patients with grade 2 varicose veins (2.51.5) (p=0.001). Mortality rate within 30 days and 1 year was significantly higher in patients with grade 3 varicose veins (p=0.001). Although the rate of bleeding within 30 days and 1 year was higher in patients with grade 3 varicose veins than in patients with grade 2 varices, the difference was not significant (p=0.087). Conclusion: EBL is an endoscopic treatment method to be preferred in patients with acute esophageal variceal hemorrhage due to its low risk of re-bleeding and low mortality rate.

Keywords:

cirrhosis, endoscopic band ligation (EBL), esophageal varices bleeding,

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