Polyglycolic acid sheets and fibrin glue decrease the risk of bleeding after endoscopic submucosal dissection of...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Surgical Innovation

Background:

• Post-endoscopic submucosal dissection (ESD) bleeding remains a significant clinical challenge for gastric neoplasms.
• High-risk patients require effective strategies to prevent bleeding after ESD procedures.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel endoscopic tissue shielding method using polyglycolic acid (PGA) sheets and fibrin glue.
• To determine the effectiveness of this shielding technique in preventing bleeding after ESD in patients at high risk.

Main Methods:

• A nonrandomized trial with historical controls was conducted at a single academic hospital.
• 45 high-risk patients undergoing ESD for gastric neoplasms were enrolled in the study group, with 41 historical controls.
• The intervention involved applying PGA sheets to the mucosal defect and securing them with fibrin glue.

Main Results:

• The post-ESD bleeding rate was significantly lower in the study group (6.7%) compared to the historical control group (22.0%).
• Statistical analysis confirmed a significant difference in bleeding rates between the two groups (P = .041).

Conclusions:

• The endoscopic tissue shielding method utilizing PGA sheets and fibrin glue demonstrates a promising approach for preventing post-ESD bleeding.
• Further investigation may be warranted, considering the nonrandomized design and small sample size.