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Polyglycolic acid sheets decrease post-endoscopic submucosal dissection bleeding in early gastric cancer: A

De Feng Li1, Feng Xiong1, Zheng Lei Xu1

  • 1Department of Gastroenterology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong Province, China.

Journal of Digestive Diseases
|June 24, 2020
PubMed
Summary
This summary is machine-generated.

Polyglycolic acid (PGA) sheets significantly reduce bleeding after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC), especially in patients on antithrombotic agents. Further research is needed to confirm effectiveness in large resections.

Keywords:
early gastric neoplasmsendoscopic submucosal dissectionmeta-analysispost-ESD bleeding

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Medical Devices

Background:

  • Endoscopic submucosal dissection (ESD) is a standard treatment for early gastric cancer (EGC).
  • Post-ESD bleeding is a significant complication, particularly in high-risk patients (e.g., those on antithrombotic agents or with large resections).

Purpose of the Study:

  • To evaluate the effectiveness of polyglycolic acid (PGA) sheets in preventing post-ESD bleeding.
  • To assess PGA sheet efficacy in high-risk EGC patients, including those on antithrombotic agents and with large mucosal resections.

Main Methods:

  • Systematic review and meta-analysis of studies on PGA sheet application after ESD for EGC.
  • Searched PubMed, Cochrane Library, and EMBASE databases.
  • Primary outcome: post-ESD bleeding rate.

Main Results:

  • Four studies (212 lesions with PGA sheets, 208 without) showed a significantly lower bleeding rate with PGA sheets (4.9% vs. 13.7%).
  • PGA sheets effectively reduced bleeding in patients on antithrombotic agents (5.5% vs. 15.2%).
  • A trend towards reduced bleeding in large resections was observed but not statistically significant (4.5% vs. 9.6%).

Conclusions:

  • PGA sheets are effective in preventing post-ESD bleeding in EGC patients, particularly those receiving antithrombotic agents.
  • Further investigation is required to confirm the benefit of PGA sheets for large mucosal resections.