Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Gastrointest Endosc. 2015 Apr;81(4):906-12. doi: 10.1016/j.gie.2014.08.028. Epub 2014 Oct 29.
The prevention of bleeding after endoscopic submucosal dissection (ESD) for gastric neoplasms is still an important problem.
To investigate the efficacy and safety of a shielding method that uses polyglycolic acid (PGA) sheets and fibrin glue to prevent post-ESD bleeding in high-risk patients.
A nonrandomized trial with historical control subjects.
A single academic hospital in Japan.
From July 2013 to February 2014, 45 ESD-induced ulcers in 41 patients with a high risk of bleeding were enrolled in a study group. Forty-one consecutive ESD-induced ulcers in 37 control subjects with a high risk of bleeding were treated in 2013 before the first enrollment.
We placed PGA sheets on the mucosal defect and fixed with fibrin glue in the study group.
The post-ESD bleeding rate.
The post-ESD bleeding occurred at a rate of 6.7% in the study group (3/45 lesions) and 22.0% in the historical control group (9/41 lesions). There was a significant difference in the post-ESD bleeding rate between the 2 groups (P = .041).
A nonrandomized trial with historical control subjects; a single-center analysis; small sample size.
The endoscopic tissue shielding method with PGA sheets and fibrin glue appears to be promising for the prevention of post-ESD bleeding. (
UMIN000011058.).
预防内镜黏膜下剥离术（ESD）后出血仍然是一个重要问题。
探讨使用聚乙二醇酸（PGA）片和纤维蛋白胶预防高危患者 ESD 后出血的屏蔽方法的疗效和安全性。
非随机试验，具有历史对照。
日本的一家学术医院。
2013 年 7 月至 2014 年 2 月，将 41 例高危出血患者的 45 个 ESD 诱导溃疡纳入研究组。2013 年首次入组前，对 37 例高危出血的连续 41 例 ESD 诱导溃疡进行了治疗。
我们在研究组将 PGA 片放置在黏膜缺损上，并使用纤维蛋白胶固定。
ESD 后出血率。
研究组 ESD 后出血率为 6.7%（3/45 例），历史对照组为 22.0%（9/41 例）。两组间 ESD 后出血率差异有统计学意义（P =.041）。
非随机试验，具有历史对照；单中心分析；样本量小。
PGA 片和纤维蛋白胶的内镜组织屏蔽方法似乎有望预防 ESD 后出血。（临床研究注册编号：UMIN000011058。）
