Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant
Abstract Background and Aim A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP)...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.13029 |
| _version_ | 1797321275320827904 |
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| author | Naohisa Yoshida Osamu Dohi Yoshikazu Inagaki Yuri Tomita Hikaru Hashimoto Reo Kobayashi Ken Inoue Ryohei Hirose Yasutaka Morimoto Yutaka Inada Takaaki Murakami Yoshito Itoh |
| author_facet | Naohisa Yoshida Osamu Dohi Yoshikazu Inagaki Yuri Tomita Hikaru Hashimoto Reo Kobayashi Ken Inoue Ryohei Hirose Yasutaka Morimoto Yutaka Inada Takaaki Murakami Yoshito Itoh |
| author_sort | Naohisa Yoshida |
| collection | DOAJ |
| description | Abstract Background and Aim A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with continuous anticoagulant. Methods This was a single‐center, retrospective study. Subjects were lesions of 2–9 mm under continuous anticoagulant from 2021 to 2023 and treated with PuraStat for POB. The definition of POB was bleeding which did not stop spontaneously by 1.0–1.5 min after resection and needed hemostasis. Successful hemostasis was defined as cessation of bleeding within 1.0–1.5 min after spraying PuraStat and the rate of it and risk factors of POB were analyzed. For comparison, cases receiving previous CSP without PuraStat were extracted from all cases with CSP (2018‐2021), and POB and DB rate (DBR) were analyzed after propensity score matching. Results One hundred twenty‐two lesions (91: direct oral anticoagulant (DOAC), 31: warfarin) with anticoagulant were analyzed and the rate of successful hemostasis with PuraStat was 92.6% (DOAC/warfarin: 93.4%/80.6%, P = 0.01). The rate of DB was 0.0%. Multivariate analysis showed that significant risk factors about unsuccessful hemostasis for POB with PuraStat were lesion size 8–9 mm (P < 0.01), warfarin (P = 0.01), and combination of antiplatelet (P = 0.01). Regarding the comparison about CSP with/without PuraStat, the clipping rate and DBR were 8.5%/94.9% (P < 0.01) and 0%/1.7% (P = 1.0). Conclusion The effects of PuraStat for POB and DB in colorectal CSP with continuous anticoagulant were acceptable. |
| first_indexed | 2024-03-08T04:56:13Z |
| format | Article |
| id | doaj.art-1828227606024a6fbe502a044504d4b2 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-03-08T04:56:13Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-1828227606024a6fbe502a044504d4b22024-02-07T15:12:06ZengWileyJGH Open2397-90702024-01-0181n/an/a10.1002/jgh3.13029Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulantNaohisa Yoshida0Osamu Dohi1Yoshikazu Inagaki2Yuri Tomita3Hikaru Hashimoto4Reo Kobayashi5Ken Inoue6Ryohei Hirose7Yasutaka Morimoto8Yutaka Inada9Takaaki Murakami10Yoshito Itoh11Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science Kyoto JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science Kyoto JapanDepartment of Gastroenterology Nishijin Hospital Kyoto JapanDepartment of Gastroenterology Koseikai Takeda Hospital Kyoto JapanDepartment of Gastroenterology Osaka General Hospital of West Japan Railway Company Osaka JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science Kyoto JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science Kyoto JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science Kyoto JapanDepartment of Gastroenterology Kyoto Saiseikai Hospital Kyoto JapanDepartment of Gastroenterology Kyoto First Red Cross Hospital Kyoto JapanDepartment of Gastroenterology Aiseikai Yamashina Hospital Kyoto JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science Kyoto JapanAbstract Background and Aim A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with continuous anticoagulant. Methods This was a single‐center, retrospective study. Subjects were lesions of 2–9 mm under continuous anticoagulant from 2021 to 2023 and treated with PuraStat for POB. The definition of POB was bleeding which did not stop spontaneously by 1.0–1.5 min after resection and needed hemostasis. Successful hemostasis was defined as cessation of bleeding within 1.0–1.5 min after spraying PuraStat and the rate of it and risk factors of POB were analyzed. For comparison, cases receiving previous CSP without PuraStat were extracted from all cases with CSP (2018‐2021), and POB and DB rate (DBR) were analyzed after propensity score matching. Results One hundred twenty‐two lesions (91: direct oral anticoagulant (DOAC), 31: warfarin) with anticoagulant were analyzed and the rate of successful hemostasis with PuraStat was 92.6% (DOAC/warfarin: 93.4%/80.6%, P = 0.01). The rate of DB was 0.0%. Multivariate analysis showed that significant risk factors about unsuccessful hemostasis for POB with PuraStat were lesion size 8–9 mm (P < 0.01), warfarin (P = 0.01), and combination of antiplatelet (P = 0.01). Regarding the comparison about CSP with/without PuraStat, the clipping rate and DBR were 8.5%/94.9% (P < 0.01) and 0%/1.7% (P = 1.0). Conclusion The effects of PuraStat for POB and DB in colorectal CSP with continuous anticoagulant were acceptable.https://doi.org/10.1002/jgh3.13029cold snare polypectomycolonoscopycolorectal polypsdelayed bleedingperioperative bleeding |
| spellingShingle | Naohisa Yoshida Osamu Dohi Yoshikazu Inagaki Yuri Tomita Hikaru Hashimoto Reo Kobayashi Ken Inoue Ryohei Hirose Yasutaka Morimoto Yutaka Inada Takaaki Murakami Yoshito Itoh Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant JGH Open cold snare polypectomy colonoscopy colorectal polyps delayed bleeding perioperative bleeding |
| title | Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant |
| title_full | Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant |
| title_fullStr | Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant |
| title_full_unstemmed | Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant |
| title_short | Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant |
| title_sort | efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant |
| topic | cold snare polypectomy colonoscopy colorectal polyps delayed bleeding perioperative bleeding |
| url | https://doi.org/10.1002/jgh3.13029 |
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