Endoscopic tissue shielding to prevent bleeding after endoscopic submucosal dissection: a prospective multicenter...

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Surgical Innovation

Background:

• Bleeding is a significant complication following endoscopic submucosal dissection (ESD).
• The endoscopic shielding method using polyglycolic acid (PGA) sheets and fibrin glue has been explored for preventing adverse events.
• This study evaluated the efficacy of the PGA shielding method in preventing post-ESD bleeding.

Purpose of the Study:

• To determine if the PGA shielding method offers additional benefit in preventing post-ESD bleeding compared to standard care.
• To assess the rate of post-ESD bleeding in patients treated with the PGA shielding method versus a control group.

Main Methods:

• A prospective, multicenter, randomized controlled trial was conducted.
• Patients at high risk for post-ESD bleeding were randomized into either the PGA group or the control group.
• In the PGA group, PGA sheets adhered with fibrin glue were applied to the ulcer floor after ESD.

Main Results:

• A total of 137 patients were included in the analysis (67 in the PGA group, 70 in the control group).
• Post-ESD bleeding occurred in 4.5% of the PGA group and 5.7% of the control group, with no statistically significant difference.
• Bleeding occurred later in the control group (median 12.5 days) compared to the PGA group (median 2 days).

Conclusions:

• The PGA shielding method did not demonstrate a significant effect in preventing post-ESD bleeding.
• No additional benefit of the PGA shielding method was observed compared to standard care for reducing post-ESD bleeding.
• Further research may be needed to explore alternative methods for bleeding prevention after ESD.