Feasibility of a modified search, coagulation, and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissection
Abstract Background Methods have been developed for preventing delayed bleeding (DB) after gastric endoscopic submucosal dissection (GESD). However, none of the methods can completely prevent DB. We hypothesized that DB could be prevented by a modified search, coagulation, and clipping (MSCC) method...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-020-01539-x |
| _version_ | 1818610154295263232 |
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| author | Satoshi Abiko Soichiro Oda Akimitsu Meno Akane Shido Sonoe Yoshida Ayumu Yoshikawa Kazuaki Harada Naoki Kawagishi Itsuki Sano Hisashi Oda Takuto Miyagishima |
| author_facet | Satoshi Abiko Soichiro Oda Akimitsu Meno Akane Shido Sonoe Yoshida Ayumu Yoshikawa Kazuaki Harada Naoki Kawagishi Itsuki Sano Hisashi Oda Takuto Miyagishima |
| author_sort | Satoshi Abiko |
| collection | DOAJ |
| description | Abstract Background Methods have been developed for preventing delayed bleeding (DB) after gastric endoscopic submucosal dissection (GESD). However, none of the methods can completely prevent DB. We hypothesized that DB could be prevented by a modified search, coagulation, and clipping (MSCC) method for patients at low risk for DB and by combining the use of polyglycolic acid sheets and fibrin glue with the MSCC method (PMSCC method) for patients at high risk for DB (antibleeding [ABI] strategy). This study assessed the technical feasibility of this novel strategy. Method We investigated 123 lesions in 121 consecutive patients who underwent GESD in Kushiro Rosai Hospital between April 2018 and January 2020. The decision for continuation or cessation of antithrombotic agents was based on the Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment. Results Oral antithrombotic agents were administered to 28 patients (22.8%). The en bloc R0 resection rate was 98.4%. The MSCC method and the PMSCC method for preventing DB were performed in 114 and 9 lesions, respectively. The median time of the MSCC method was 16 min, and the median speed (the resection area divided by the time of method used) was 3.6 cm2/10 min. The median time of the PMSCC method was 59 min, and the median speed was 1.3 cm2/10 min. The only delayed procedural adverse event was DB in 1 (0.8%) of the 123 lesions. Conclusions The ABI strategy is feasible for preventing DB both in patients at low risk and in those at high risk for DB after GESD, whereas the PMSCC method may be necessary for reduction of time. |
| first_indexed | 2024-12-16T15:09:55Z |
| format | Article |
| id | doaj.art-727bd25669d949138d7699efaf142d4c |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-16T15:09:55Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-727bd25669d949138d7699efaf142d4c2022-12-21T22:27:00ZengBMCBMC Gastroenterology1471-230X2021-02-012111710.1186/s12876-020-01539-xFeasibility of a modified search, coagulation, and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissectionSatoshi Abiko0Soichiro Oda1Akimitsu Meno2Akane Shido3Sonoe Yoshida4Ayumu Yoshikawa5Kazuaki Harada6Naoki Kawagishi7Itsuki Sano8Hisashi Oda9Takuto Miyagishima10Department of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalDepartment of Gastroenterology, Kushiro Rosai HospitalAbstract Background Methods have been developed for preventing delayed bleeding (DB) after gastric endoscopic submucosal dissection (GESD). However, none of the methods can completely prevent DB. We hypothesized that DB could be prevented by a modified search, coagulation, and clipping (MSCC) method for patients at low risk for DB and by combining the use of polyglycolic acid sheets and fibrin glue with the MSCC method (PMSCC method) for patients at high risk for DB (antibleeding [ABI] strategy). This study assessed the technical feasibility of this novel strategy. Method We investigated 123 lesions in 121 consecutive patients who underwent GESD in Kushiro Rosai Hospital between April 2018 and January 2020. The decision for continuation or cessation of antithrombotic agents was based on the Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment. Results Oral antithrombotic agents were administered to 28 patients (22.8%). The en bloc R0 resection rate was 98.4%. The MSCC method and the PMSCC method for preventing DB were performed in 114 and 9 lesions, respectively. The median time of the MSCC method was 16 min, and the median speed (the resection area divided by the time of method used) was 3.6 cm2/10 min. The median time of the PMSCC method was 59 min, and the median speed was 1.3 cm2/10 min. The only delayed procedural adverse event was DB in 1 (0.8%) of the 123 lesions. Conclusions The ABI strategy is feasible for preventing DB both in patients at low risk and in those at high risk for DB after GESD, whereas the PMSCC method may be necessary for reduction of time.https://doi.org/10.1186/s12876-020-01539-xDelayed bleedingGastric endoscopic submucosal dissectionPolyglycolic acid sheets |
| spellingShingle | Satoshi Abiko Soichiro Oda Akimitsu Meno Akane Shido Sonoe Yoshida Ayumu Yoshikawa Kazuaki Harada Naoki Kawagishi Itsuki Sano Hisashi Oda Takuto Miyagishima Feasibility of a modified search, coagulation, and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissection BMC Gastroenterology Delayed bleeding Gastric endoscopic submucosal dissection Polyglycolic acid sheets |
| title | Feasibility of a modified search, coagulation, and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissection |
| title_full | Feasibility of a modified search, coagulation, and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissection |
| title_fullStr | Feasibility of a modified search, coagulation, and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissection |
| title_full_unstemmed | Feasibility of a modified search, coagulation, and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissection |
| title_short | Feasibility of a modified search, coagulation, and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissection |
| title_sort | feasibility of a modified search coagulation and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissection |
| topic | Delayed bleeding Gastric endoscopic submucosal dissection Polyglycolic acid sheets |
| url | https://doi.org/10.1186/s12876-020-01539-x |
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