Polyglycolic Acid Sheet Application to Refractory Delayed Bleeding After Rectal Endoscopic Submucosal Dissection: A...

Area of Science:

• Gastroenterology
• Surgical Oncology

Background:

• Endoscopic submucosal dissection (ESD) is a minimally invasive technique for removing gastrointestinal tumors.
• Delayed bleeding is a potential complication following rectal ESD, sometimes requiring complex management.

Purpose of the Study:

• To evaluate the efficacy of polyglycolic acid (PGA) sheets in managing refractory delayed bleeding after rectal ESD.

Main Methods:

• A patient underwent rectal ESD for a 28 mm tumor.
• Recurrent delayed bleeding episodes were treated with hemostatic forceps, clip closure, and PuraStat, with limited success.
• Polyglycolic acid (PGA) sheets were applied to the ulcer bed during the fourth bleeding episode.

Main Results:

• The patient experienced multiple delayed bleeding episodes after rectal ESD.
• Previous treatments, including clip closure and PuraStat, failed to achieve sustained hemostasis.
• Application of PGA sheets resulted in continuous hemostasis without complications, and the ulcer continued to heal.

Conclusions:

• Polyglycolic acid (PGA) sheets appear to be a safe and effective option for managing refractory delayed bleeding after rectal ESD.
• This method provides a promising alternative for cases where conventional treatments are insufficient.