Polyglycolic acid sheets and fibrin glue decrease the risk of bleeding after endoscopic submucosal dissection of gastric neoplasms (with video) - 21/06/16
Abstract |
Background |
The prevention of bleeding after endoscopic submucosal dissection (ESD) for gastric neoplasms is still an important problem.
Objective |
To investigate the efficacy and safety of a shielding method that uses polyglycolic acid (PGA) sheets and fibrin glue to prevent post-ESD bleeding in high-risk patients.
Design |
A nonrandomized trial with historical control subjects.
Setting |
A single academic hospital in Japan.
Patients |
From July 2013 to February 2014, 45 ESD-induced ulcers in 41 patients with a high risk of bleeding were enrolled in a study group. Forty-one consecutive ESD-induced ulcers in 37 control subjects with a high risk of bleeding were treated in 2013 before the first enrollment.
Interventions |
We placed PGA sheets on the mucosal defect and fixed with fibrin glue in the study group.
Main Outcome Measurements |
The post-ESD bleeding rate.
Results |
The post-ESD bleeding occurred at a rate of 6.7% in the study group (3/45 lesions) and 22.0% in the historical control group (9/41 lesions). There was a significant difference in the post-ESD bleeding rate between the 2 groups (P = .041).
Limitations |
A nonrandomized trial with historical control subjects; a single-center analysis; small sample size.
Conclusions |
The endoscopic tissue shielding method with PGA sheets and fibrin glue appears to be promising for the prevention of post-ESD bleeding. (Clinical trial registration number: UMIN000011058.)
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : ESD, PGA
Mappa
| DISCLOSURE: The following author disclosed financial relationships relevant to this publication: M. Fujishiro: Speaker for Olympus, Boehringer-Ingelheim, Otsuka Pharmaceutical, Astrazeneca Pharmaceutical, Daiichi-Sankyo Pharmaceutical, Eisai Corporation, Aska Pharmaceutical, Nihon Pharmaceutical, Pentax, Mitsubishi Tanabe Pharma Corporation, Amco Corporation, and Takeda Pharmaceutical; Unrestricted Research Grants from Astellas Pharmaceutical, Takeda Pharmaceutical, Zeria Pharmaceutical, Otsuka Pharmaceutical, Astrazeneca Pharmaceutical, Dainihon-Sumitomo Pharmaceutical, Taiho Pharmaceutical, Ajinomoto Pharmaceutical, and Eisai; Nonfinancial Support from HOYA Pentax, Olympus Medical Systems, and Fujifilm; and Honoraria from Olympus Medical Systems, HOYA Pentax, Eisai, MSD, Daiichi-Sankyo Pharmaceutical, Astrazeneca Pharmaceutical, Aska Pharmaceutical, Taisho-Toyama Pharmaceutical, Otsuka Pharmaceutical, Zeria Pharmaceutical, Takeda Pharmaceutical, Astellas Pharmaceutical, Seikagaku Corp, Johnson & Johnson, Ajinomoto Pharmaceutical, Amco, Novartis Pharmaceutical, Boston Scientific, and, Boehringer-Ingelheim. All other authors disclosed no financial relationships relevant to this publication. |
Vol 81 - N° 4
P. 906-912 - aprile 2015 Ritorno al numero
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