Abstract: Objective To investigate the effect of endoscopic treatment for liver cirrhosis complicated with esophageal and gastric varices accompanied by upper gastrointestinal(GI) mass. Methods Clinical data of 18 patients were retrospectively collected, who underwent menstrual endoscopic treatment for esophageal gastric varices with upper gastrointestinal neoplasm in Beijing Friendship Hospital, Capital Medical University, Department of Gastroenterology since January 2010 to July 2021. The pathological results after upper gastrointestinal neoplasm resection indicated 4 cases of early esophageal cancer, 6 cases of early gastric cancer, and 8 cases of gastric hyperplastic polyp. The varices were diagnosed with LDRf classification method. The esophageal varices were treated with ligation operation or hardening treatment. The gastric varices were treated with embolization. The upper gastrointestinal tract neoplasm was treated with endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). The clinical manifestations, laboratory examination, endoscopic performance, endoscopic treatment, pathological results, and follow-up were summarized and analyzed. Results A total of 18 patients (10 males and 8 females) were aged 37-81 years old, with an average age of (65.88±9.09) years old. According to Child-Pugh grading of liver function, there were 15 patients with grade A and 3 patients with grade B, 4 patients with platelet less than 50×10⁹/L, 3 patients with prothrombin time activity (PTA) less than 60%, and international normalized ratio (INR) of all the cases was less than 1.5. Among all the cases, 4 cases had the digestive tract neoplasm located at the end of the esophagus or stomach varicose vein on or close to, and 8 patients had a history of ruptured esophageal gastric varices bleeding and underwent the esophageal or gastric varices endoscopic treatment, five of which were treated with leading endoscopic esophageal or gastric varices endoscopic treatment. The patients underwent elective review gastroscope after treatment one to six months. The upper digestive tract masses were treated with EMR or ESD after the improvement of esophageal or gastric varices. Follow-up observation was made on the endoscopic treatment of esophageal and gastric varices, and no bleeding, perforation or other serious complications occurred during or after EMR or ESD. The lesions were completely removed, and the postoperative pathology showed that the incision margin was clean. None of the patients died at 12 months of follow-up after upper GI mass resection. Conclusion EMR and ESD are safe and effective for the treatment of esophageal and gastric varices with upper digestive tract early cancer and polyps and other masses in cirrhosis. Endoscopic intervention of esophageal and gastric varices at an appropriate time could reduce postoperative bleeding and other complications.

Key words: cirrhosis, esophagogastric varices, upper gastrointestinal mass, endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD)