Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan.
Gastroenterological Surgery, Kagawa University, Kita, Japan.
Minim Invasive Ther Allied Technol. 2022 Apr;31(4):548-555. doi: 10.1080/13645706.2020.1871370. Epub 2021 Jan 19.
The management of postoperative bleeding, after gastric endoscopic submucosal dissection (ESD), has become particularly important because of the recent increase in antithrombotic use. Endoscopic shielding with polyglycolic acid (PGA) sheets has been shown to be effective. However, shrinkage and early displacement of the sheet remain challenges. This study aimed to determine the efficacy and safety of our developed method, named wafer paper and ring-mounted PGA sheet (WaRP).
Twenty-four patients with antithrombotic uptake who underwent the WaRP method following gastric ESD were retrospectively examined. This involved the delivery of a PGA sheet wrapped in wafer paper with ring-thread, and its fixation on the gastric floor using hemoclips. The primary outcome was the technical success rate of the WaRP, and several secondary outcomes were evaluated.
The technical success rate of WaRP was 100%. The procedure lasted a mean of 10.5 min (SD 6.7 min). The prevalence of complete retention at follow-up endoscopy was 83.3% (20/24). There were no WaRP-associated complications, but post-ESD hemorrhage occurred in two patients undergoing hemodialysis (8.3%).
The WaRP method is a simple and reliable means of PGA sheet delivery and placement that reduces the incidence of post-ESD hemorrhage.
由于抗血栓药物的广泛应用，胃内镜黏膜下剥离术（ESD）后术后出血的管理变得尤为重要。聚乙二醇酸（PGA）片的内镜屏蔽已被证明是有效的。然而，片材的收缩和早期移位仍然是挑战。本研究旨在确定我们开发的方法，即“ wafer paper and ring-mounted PGA sheet (WaRP)”的疗效和安全性。
回顾性分析了 24 例接受抗血栓药物治疗且在胃 ESD 后采用 WaRP 方法的患者。该方法涉及用包裹有 wafer paper 的 PGA 片，并使用环纹夹将其固定在胃底。主要结果是 WaRP 的技术成功率，还评估了几个次要结果。
WaRP 的技术成功率为 100%。该过程平均持续 10.5 分钟（SD 6.7 分钟）。在随访内镜检查时，完全保留的比例为 83.3%（20/24）。没有与 WaRP 相关的并发症，但在接受血液透析的 2 名患者（8.3%）中发生了 ESD 后出血。
WaRP 方法是一种简单可靠的 PGA 片输送和放置方法，可降低 ESD 后出血的发生率。
