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Efficacy of a new hemostatic forceps during gastric endoscopic submucosal dissection: A prospective randomized controlled trial
Author(s) -
Tanaka Shinwa,
Toyonaga Takashi,
Morita Yoshinori,
Ishida Tsukasa,
Hoshi Namiko,
Grimes Kevin L,
Ohara Yoshiko,
Yoshizaki Tetsuya,
Kawara Fumiaki,
Umegaki Eiji,
Azuma Takeshi
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13599
Subject(s) - medicine , hemostasis , endoscopic submucosal dissection , randomized controlled trial , forceps , surgery , perforation , adverse effect , prospective cohort study , anesthesia , materials science , punching , metallurgy
Background and Aim Currently, endoscopic submucosal dissection (ESD) is a widely accepted standard treatment for early gastric cancer, but one challenging aspect of ESD is hemostasis. We developed a new hemostatic forceps (FD‐Y0007) with the aim of achieving more effective hemostasis and investigated the hemostatic ability of the FD‐Y0007 during gastric ESD in humans. Methods This study was a prospective randomized controlled trial, which was conducted at a cancer referral center. Sixty‐six patients who were scheduled to undergo ESD were enrolled and randomly assigned to either the Coagrasper or the FD‐Y0007, which was used for hemostasis throughout the case. The primary end point was the time required to obtain hemostasis, which was measured for the first episode of bleeding during each case. Results Hemostasis time for the first bleeding episode during ESD was 73.0 s for the Coagrasper and 21.5 s for the FD‐Y0007 ( P < 0.001). When all episodes of bleeding were included, hemostasis time was 56.8 s in the Coagrasper group and 25.5 s in FD‐Y0007group ( P < 0.0001). The frequency of adverse events (perforation: 3.4% vs 7.1%; delayed bleeding: 0% vs 0%) was not significantly different between the two groups. Conclusions Compared with the Coagrasper, the FD‐Y0007 efficiently reduces the hemostatic time during gastric ESD with no increase in adverse events.