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A novel self-assembling peptide for hemostasis during endoscopic submucosal dissection: a randomized controlled
Sharmila Subramaniam1, Kesavan Kandiah1,2, Fergus Chedgy1,3
1Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK.
Endoscopy
|July 18, 2020
Summary
Purastat significantly reduced heat therapy during endoscopic submucosal dissection (ESD). This topical hemostat also improved wound healing, offering a safer alternative to traditional methods.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Surgical hemostasis
Background:
- Endoscopic submucosal dissection (ESD) carries a risk of bleeding, often managed with diathermy, which can cause thermal injury.
- Purastat, a topical hemostat, presents a potential alternative to reduce heat therapy during ESD.
- This study evaluated Purastat's efficacy in controlling bleeding and its impact on healing during ESD.
Purpose of the Study:
- To assess the reduction in heat therapy usage with Purastat compared to standard diathermy in ESD.
- To compare procedure length, hemostasis time, and delayed bleeding rates between Purastat and control groups.
- To evaluate the impact of Purastat on wound healing after ESD.
Main Methods:
- A single-center randomized controlled trial involving 101 patients undergoing ESD.
- Participants were randomized to receive either standard diathermy or Purastat for bleeding control.
- Follow-up endoscopy at 4 weeks assessed wound healing outcomes.
Main Results:
- Significantly less heat therapy was used in the Purastat group (49.3%) versus the control group (99.6%) (P < 0.001).
- No significant differences were observed in procedure length, hemostasis time, or delayed bleeding rates.
- Complete wound healing at 4 weeks was higher in the Purastat group (48.8%) compared to controls (25.0%) (P = 0.02).
Conclusions:
- Purastat effectively reduces the need for heat therapy during ESD-related bleeding.
- Purastat demonstrates potential for enhancing post-resection wound healing.
- Topical hemostats like Purastat may offer a safer approach to managing bleeding in ESD procedures.
