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Polysaccharide hemostatic system for hemostasis management in colorectal endoscopic mucosal resection
Author(s) -
Huang Rui,
Pan Yanglin,
Hui Na,
Guo Xuegang,
Zhang Linhui,
Wang Xiangping,
Zhang Rongchun,
Luo Hui,
Zhou Xiong,
Tao Qin,
Liu Zhiguo,
Wu Kaichun
Publication year - 2014
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12054
Subject(s) - medicine , hemostasis , colonoscopy , endoscopic mucosal resection , surgery , endoscopy , severe bleeding , forceps , hemostatics , adverse effect , gastrointestinal bleeding , polypectomy , colorectal cancer , cancer
Background A new polysaccharide hemostatic system ( EndoClot TM ) was recently developed for bleeding control in gastrointestinal tract endoscopy; however, its efficacy and safety is not yet well established in colorectal endoscopic mucosal resection ( EMR ). The aim of the present study was to observe the bleeding control effect after EMR in the colorectum. Patients and Methods EndoClot TM was applied immediately to mucosal defects after resection whether or not there was post‐resection bleeding. Bleeding was monitored post‐procedurally by clinical findings including positive stool occult blood test and by second‐look endoscopy. Hemostasis, rebleeding rates and treatment‐related complications were observed. Results In total, 82 patients were enrolled, totaling 181 lesions. Among them, 20 lesions in 18 cases showed bleeding immediately after the procedure. Among them, two lesions were treated by combined hot biopsy forceps, and complete hemostasis was achieved in all cases without surgery. It took 1.1 min (0.4–2.1) tocarry out hemostasis treatment. Rebleeding with positive stool test and colonoscopy recurred in three of 18 patients with immediate post‐procedural bleeding. In patients without immediate post‐procedural bleeding, three patients were confirmed with delayed bleeding. No major adverse events of treatment or procedure‐related serious adverse events were reported during a 30‐day follow up. Colonoscopy was done in selected patients at 30 days and full recovery of mucosal defect was achieved in all cases. Conclusion Polysaccharide hemostatic system effectively achieves hemostasis in controlling and preventing EMR ‐related bleeding with the advantage of simple application; thus it might be a useful alternative in treating bleeding endoscopically.