Secure intravariceal sclerotherapy with red dichromatic imaging decreases the recurrence rate of esophageal varices: A propensity score matching analysis

Background Red dichromatic imaging (RDI) is next‐generation image‐enhanced endoscopy technique released in July 2020. We previously reported that RDI can predict esophageal varices (EV) depth and decrease their recurrence rate by accurate intravariceal injections during endoscopic injection scleroth...

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Bibliographic Details
Published in:Journal of hepato-biliary-pancreatic sciences 2021-05, Vol.28 (5), p.431-442
Main Authors: Furuichi, Yoshihiro, Abe, Masakazu, Kasai, Yoshitaka, Takeuchi, Hirohito, Yoshimasu, Yuu, Itoi, Takao
Format: Article
Language:English
Subjects:
dual red imaging
endoscopic injection sclerotherapy
endoscopic ultrasound
esophageal varices
Esophagus
image‐enhanced endoscopy
red dichromatic imaging
Sclerotherapy
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Summary:Background Red dichromatic imaging (RDI) is next‐generation image‐enhanced endoscopy technique released in July 2020. We previously reported that RDI can predict esophageal varices (EV) depth and decrease their recurrence rate by accurate intravariceal injections during endoscopic injection sclerotherapy (EIS) using unreleased prototype RDI endoscope. In this study, we analyzed whether RDI improves the overall survival (OS) rate and whether it is more accurate independent predictor of EV recurrence than white light imaging (WLI), using propensity score matching. Methods A total of 179 patients were enrolled. Patients were matched for age, platelet count, liver function, EV size, luminal diameter, and EV depth using propensity score matching, and 78 patients (RDI, 39; WLI, 39) were finally matched. Primary endpoints were OS and recurrence rates. Secondary endpoints were success rate of intravariceal injection, operating time, incidence of adverse events (AEs), and predictors associated with OS and recurrence rates. Results There was no difference in OS (P = .193), but the cumulative recurrence rate in the RDI group was significantly lower than in the WLI group (P = .002). Success rates of intrainjection, operating time, and incidence of AEs were better in the RDI group (p = 0.035, .026, and .0019, respectively). Independent predictors associated with recurrence rate by Cox proportional regression were RDI function and luminal diameter (P 
ISSN:1868-6974
1868-6982
DOI:10.1002/jhbp.894