Suction sclerotherapy for the treatment of esophageal varices: a report of a preliminary feasibility study.

We report a new treatment modality for esophageal varices, suction sclerotherapy, which was designed to lift away mucosa and submucosa during treatment to prevent deep injection and resultant esophageal ulcerations. In order to compare the posttreatment complications of suction sclerotherapy against freehand sclerotherapy, we randomized 4 mongrel dogs to receive ten injections of 0.5-ml aliquots of absolute alcohol into the esophagus by either the suction or freehand sclerotherapy technique. The animals were humanely sacrificed after 48 h and examined. A total of five large, deep, confluent ulcers, free perforation, and lung abscess were seen in the animals randomized to freehand sclerotherapy. In contrast, a total of 14 shallow, discrete, erythematous lesions were found in the suction sclerotherapy group; none of these lesions extended deeper than the submucosa. We conclude that suction sclerotherapy produced local complications limited to the submucosa which were less severe as compared with freehand sclerotherapy.

Duke Scholars

Author Theodore N. Pappas Surgery, Minimally Invasive Surgery