MINIMALLY INVASIVE TECHNOLOGIES OF TREATMENT OF NON-VARICOSE ESOPHAGOINTESTINAL GASTRIC BLEEDING

OBJECTIVE. The enhancement of direct results of treatment in patients with a bleeding gastro-duodenal ulcer and the Mallory–Weise syndrome using endoscopic and endovascular methods of hemostasis.MATERIAL AND METHODS. In this paper, the treatment results of the 253 patients with Mallory–Weise syndrom...

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Main Authors: К. G. Kubachev, Е. U. Kachesov, О. A. Petropavlovskaya, O. S. Danilin, D. A. Tvorogov
Format: Article
Language:Russian
Published: Pavlov First Saint Petersburg State Medical University 2018-04-01
Series:Вестник хирургии имени И.И. Грекова
Subjects:
Online Access:https://www.vestnik-grekova.ru/jour/article/view/861
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author К. G. Kubachev
Е. U. Kachesov
О. A. Petropavlovskaya
O. S. Danilin
D. A. Tvorogov
author_facet К. G. Kubachev
Е. U. Kachesov
О. A. Petropavlovskaya
O. S. Danilin
D. A. Tvorogov
author_sort К. G. Kubachev
collection DOAJ
description OBJECTIVE. The enhancement of direct results of treatment in patients with a bleeding gastro-duodenal ulcer and the Mallory–Weise syndrome using endoscopic and endovascular methods of hemostasis.MATERIAL AND METHODS. In this paper, the treatment results of the 253 patients with Mallory–Weise syndrome and the results of the 1063 patients with a bleeding gastro-duodenal ulcer are analyzed.RESULTS. An endoscopic hemostasis was conducted for all patients with a Mallory–Weise syndrome. For patients with bleeding ulcer: the injection therapy and unipolar coagulation were done for 238 patients (the bleeding recurrence was detected in 21 cases (8.8 %)); the injection therapy and argon plasma therapy were conducted for 341 patients (the bleeding recurrence was detected in 19 cases (5.6 %)); the injection therapy and clipping of vessels were conducted for 236 patients (the bleeding recurrence was detected in 11 cases (4.7 %)); the ulcer ligation was done for 98 patients without bleeding recurrences. 151 persons were treated only with the conservative treatment, while the recurrence was detected with 49 persons (32.5 %). The primary surgical treatment was done for 46 (4.3 %) patients, who had the traces of a heavy blood loss but it was not possible to visualize its source. Two patients died. 106 patients underwent an X-ray endovascular surgical procedure aimed at reaching the hemostasis. 100 patients of them had a bleeding recurrence and 6 of them had a comorbidity index over 30 points and a high risk of bleeding recurrence. One person with an acute cardiac insufficiency died.CONCLUSION. The bleeding recurrence and a high comorbidity index provide an evidence for undertaking X-ray endovascular method of hemostasis.
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spelling doaj.art-2a293a64421d47a7a4e6c21d1e88d5042023-03-13T08:09:16ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252018-04-011772252910.24884/0042-4625-2018-177-2-25-29837MINIMALLY INVASIVE TECHNOLOGIES OF TREATMENT OF NON-VARICOSE ESOPHAGOINTESTINAL GASTRIC BLEEDINGК. G. Kubachev0Е. U. Kachesov1О. A. Petropavlovskaya2O. S. Danilin3D. A. Tvorogov4Federal State Budgetary Educational Institution of Higher Education «North-Western State Medical University named after I. I. Mechnikov»Federal State Budgetary Educational Institution of Higher Education «North-Western State Medical University named after I. I. Mechnikov»Federal State Budgetary Educational Institution of Higher Education «North-Western State Medical University named after I. I. Mechnikov»Federal State Budgetary Educational Institution of Higher Education «North-Western State Medical University named after I. I. Mechnikov»Federal State Budgetary Educational Institution of Higher Education «North-Western State Medical University named after I. I. Mechnikov»OBJECTIVE. The enhancement of direct results of treatment in patients with a bleeding gastro-duodenal ulcer and the Mallory–Weise syndrome using endoscopic and endovascular methods of hemostasis.MATERIAL AND METHODS. In this paper, the treatment results of the 253 patients with Mallory–Weise syndrome and the results of the 1063 patients with a bleeding gastro-duodenal ulcer are analyzed.RESULTS. An endoscopic hemostasis was conducted for all patients with a Mallory–Weise syndrome. For patients with bleeding ulcer: the injection therapy and unipolar coagulation were done for 238 patients (the bleeding recurrence was detected in 21 cases (8.8 %)); the injection therapy and argon plasma therapy were conducted for 341 patients (the bleeding recurrence was detected in 19 cases (5.6 %)); the injection therapy and clipping of vessels were conducted for 236 patients (the bleeding recurrence was detected in 11 cases (4.7 %)); the ulcer ligation was done for 98 patients without bleeding recurrences. 151 persons were treated only with the conservative treatment, while the recurrence was detected with 49 persons (32.5 %). The primary surgical treatment was done for 46 (4.3 %) patients, who had the traces of a heavy blood loss but it was not possible to visualize its source. Two patients died. 106 patients underwent an X-ray endovascular surgical procedure aimed at reaching the hemostasis. 100 patients of them had a bleeding recurrence and 6 of them had a comorbidity index over 30 points and a high risk of bleeding recurrence. One person with an acute cardiac insufficiency died.CONCLUSION. The bleeding recurrence and a high comorbidity index provide an evidence for undertaking X-ray endovascular method of hemostasis.https://www.vestnik-grekova.ru/jour/article/view/861mallory–weise syndromebleeding stomach and duodenal ulceendoscopic and endovascular hemostasis
spellingShingle К. G. Kubachev
Е. U. Kachesov
О. A. Petropavlovskaya
O. S. Danilin
D. A. Tvorogov
MINIMALLY INVASIVE TECHNOLOGIES OF TREATMENT OF NON-VARICOSE ESOPHAGOINTESTINAL GASTRIC BLEEDING
Вестник хирургии имени И.И. Грекова
mallory–weise syndrome
bleeding stomach and duodenal ulce
endoscopic and endovascular hemostasis
title MINIMALLY INVASIVE TECHNOLOGIES OF TREATMENT OF NON-VARICOSE ESOPHAGOINTESTINAL GASTRIC BLEEDING
title_full MINIMALLY INVASIVE TECHNOLOGIES OF TREATMENT OF NON-VARICOSE ESOPHAGOINTESTINAL GASTRIC BLEEDING
title_fullStr MINIMALLY INVASIVE TECHNOLOGIES OF TREATMENT OF NON-VARICOSE ESOPHAGOINTESTINAL GASTRIC BLEEDING
title_full_unstemmed MINIMALLY INVASIVE TECHNOLOGIES OF TREATMENT OF NON-VARICOSE ESOPHAGOINTESTINAL GASTRIC BLEEDING
title_short MINIMALLY INVASIVE TECHNOLOGIES OF TREATMENT OF NON-VARICOSE ESOPHAGOINTESTINAL GASTRIC BLEEDING
title_sort minimally invasive technologies of treatment of non varicose esophagointestinal gastric bleeding
topic mallory–weise syndrome
bleeding stomach and duodenal ulce
endoscopic and endovascular hemostasis
url https://www.vestnik-grekova.ru/jour/article/view/861
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AT oapetropavlovskaya minimallyinvasivetechnologiesoftreatmentofnonvaricoseesophagointestinalgastricbleeding
AT osdanilin minimallyinvasivetechnologiesoftreatmentofnonvaricoseesophagointestinalgastricbleeding
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