scholarly journals Comparison of Hemostatic Efficacy of Argon Plasma Coagulation with and without Distilled Water Injection in Treating High-Risk Bleeding Ulcers

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yuan-Rung Li ◽  
Ping-I Hsu ◽  
Huay-Min Wang ◽  
Hoi-Hung Chan ◽  
Kai-Ming Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Hospital Stay ◽  
Combined Therapy ◽  
Argon Plasma Coagulation ◽  
Water Injection ◽  
Argon Plasma ◽  
Distilled Water ◽  
Plasma Coagulation ◽  
Hemostatic Efficacy ◽  
Bleeding Ulcers

Background. Argon plasma coagulation (APC) is useful to treat upper gastrointestinal bleeding, but its hemostatic efficacy has received little attention.Aims. This investigation attempted to determine whether additional endoscopic injection before APC could improve hemostatic efficacy in treating high-risk bleeding ulcers.Methods. From January 2007 to April 2011, adult patients with high-risk bleeding ulcers were included. This investigation compared APC plus distilled water injection (combined group) to APC alone for treating high-risk bleeding ulcers. Outcomes were assessed based on initial hemostasis, surgery, blood transfusion, hospital stay, rebleeding, and mortality at 30 days posttreatment.Results. Totally 120 selected patients were analyzed. Initial hemostasis was accomplished in 59 patients treated with combined therapy and 57 patients treated with APC alone. No significant differences were noted between these groups in recurred bleeding, emergency surgery, 30-day mortality, hospital stay, or transfusion requirements. Comparing the combined end point of mortality plus the failure of initial hemostasis, rebleeding, and the need for surgery revealed an advantage for the combined group(P=0.040).Conclusions. Endoscopic therapy with APC plus distilled water injection was no more effective than APC alone in treating high-risk bleeding ulcers, whereas combined therapy was potentially superior for patients with poor overall outcomes.

scholarly journals Adrenaline Injection Plus Argon Plasma Coagulation versus Adrenaline Injection Plus Hemoclips for Treating High-Risk Bleeding Peptic Ulcers: A Prospective, Randomized Trial

2009 ◽  
Vol 23 (10) ◽  
pp. 699-704 ◽  
Author(s):  
Seyed Alireza Taghavi ◽  
Seyed Mohammad Soleimani ◽  
Seyed Mohammad Kazem Hosseini-Asl ◽  
Ahad Eshraghian ◽  
Hajar Eghbali ◽  
...  
Keyword(s):  
High Risk ◽  
Randomized Trial ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Prospective Randomized Trial ◽  
Peptic Ulcers ◽  
Plasma Coagulation ◽  
End Point ◽  
Bleeding Peptic Ulcers ◽  
Adrenaline Injection

BACKGROUND/OBJECTIVE: Several combination endoscopic therapies are currently in use. The present study aimed to compare argon plasma coagulation (APC) + adrenaline injection (AI) with hemoclips + AI for the treatment of high-risk bleeding peptic ulcers.METHODS: In a prospective randomized trial, 172 patients with major stigmata of peptic ulcer bleeding were randomly assigned to receive APC + AI (n=89) or hemoclips + AI (n=83). In the event of rebleeding, the initial modality was used again. Patients in whom treatment or retreatment was unsuccessful underwent emergency surgery. The primary end point of rebleeding rate and secondary end points of initial and definitive hemostasis need for surgery and mortality were compared between the two groups.RESULTS: The two groups were similar in all background variables. Definitive hemostasis was achieved in 85 of 89 (95.5%) of the APC + AI and 82 of 83 (98.8%) of the hemoclips + AI group (P=0.206). The mean volume of adrenaline injected in the two groups was equal (20.7 mL; P=0.996). There was no significant difference in terms of initial hemostasis (96.6% versus 98.8%; P=0.337), rate of rebleeding (11.2% versus 4.8%; P=0.124), need for surgery (4.5% versus 1.2%; P=0.266) and mortality (2.2% versus 1.2%; P=0.526). When compared for the combined end point of mortality plus rebleeding and the need for surgery, there was an advantage for the hemoclip group (6% versus 15.7%, P=0.042).CONCLUSION: Hemoclips + AI has no superiority over APC + AI in treating patients with high-risk bleeding peptic ulcers. Hemoclips + AI may be superior when a combination of all negative outcomes is considered.

scholarly journals Endoscopic treatment for chronic radiation proctitis

2020 ◽  
Vol 10 (3-4) ◽  
pp. 65-72
Author(s):  
E. A. Grishina ◽  
K. V. Shishin ◽  
I. Yu. Nedoluzhko ◽  
N. A. Kurushkina ◽  
L. V. Shumkina ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
High Risk ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Radiation Proctitis ◽  
Bipolar Coagulation ◽  
Endoscopic Techniques ◽  
Plasma Coagulation ◽  
Chronic Radiation Proctitis ◽  
Chronic Radiation

The preferred method in detection and staging of chronic radiation proctitis is colonoscopy. Moreover, endoscopy is used widely in treating patients with this disease. The main goal of endoscopic techniques is hemostasis and elimination of vascular transformations. This includes formalin application, band ligation, various types of laser irradiation, bipolar coagulation and cryotherapy. However, these methods are associated with relatively high risk of complications, whereas argon plasma coagulation and radiofrequency ablation are effective, relatively safe techniques for chronic radiation proctitis and well tolerated by patients.

scholarly journals Innovative Endoscopic Technologies in the Complex Treatment of Patients with Unstable Stopped Gastroduodenal Bleeding

2021 ◽  
Vol 11 (1) ◽  
pp. 24-28
Author(s):  
Evgeniy Cherednikov ◽  
Sergey Barannikov ◽  
Igor Yuzefovich ◽  
Galina Polubkova ◽  
Yuri Maleev ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Length Of Hospital Stay ◽  
Aminocaproic Acid ◽  
Endoscopic Hemostasis ◽  
Recurrent Bleeding ◽  
Complex Treatment ◽  
Plasma Coagulation ◽  
Hemostatic Agents

Background: The aim of our research was to improve the results of treatment of patients with unstable bleeding gastroduodenal ulcers (GDUs) through the use of innovative endoscopic technologies in the complex treatment of gastroduodenal bleeding (GDB). Methods and results: The study included 132 patients with unstable ulcerative GDB. Among all patients with GDB, there were 95(71.96%) men and 37(28.04%) women. The average age of patients was 56.1±18.45 years. Among the sources of gastroduodenal ulcer bleeding, duodenal ulcers complicated by bleeding predominated were observed in 77(58.3%) patients, bleeding gastric ulcers and ulcers of gastroenteroanastomosis areas in 49(37.7%) and 6(4.6%) patients, respectively. According to the endoscopic classification (J. Forrest, 1974), continued bleeding (Forrest Ia-Ib) was observed in 44(33.3%) patients, threat of rebleeding (Forrest IIa-IIb) in 88(66.7%) patients. All patients were divided, by random sampling, into two equivalent groups: the main group (MG, n=66) and the comparison group (CG, n=66). In the treatment of MG patients, an individual approach was applied that used the injection of ε-aminocaproic acid, argon-plasma coagulation, and the endoscopic pneumatic applications of hemostatic agents (Zhelplastan and the patient's platelet-rich auto-plasma) and granular sorbents (Aseptisorb-A, Aseptisorb-D). In CG, traditional methods of endoscopic hemostasis (injection method with ε-aminocaproic acid and vasoconstrictor drugs, argon plasma coagulation, etc.) were used without granular sorbents and innovative hemostatic agents. In patients with the Forrest Ia-Ib bleeding, primary EH was achieved in 95.2% of cases in the MG and in 91.3% of cases in the CG (P>0.05). In patients with the Forrest IIa-IIb bleeding, effectiveness of endoscopic prevention of recurrent bleeding was achieved in 95.5% of cases in the MG and in 81.4% of cases in the CG (P=0.047). Mortality rate was 1.5% in the MG and 4.5% in the CG (P>0.05). In the MG and CG, the overall frequency of recurrent bleeding from GDUs, the operational activity, and the length of hospital stay were 15.2% and 4.5% (P=0.041), 12.1% and 1.5% (P=0.033), and 11.1±0.6 days and 9.2±0.4 days (P<0.01), respectively. Conclusion: The developed method for the complex treatment of patients with unstable GDB, based on the optimization of emergency and preventive endoscopic hemostasis, indicates that the use of therapeutic endoscopy to prevent bleeding recurrences with hemostatic agents and granular sorbents improves the reliability of endoscopic hemostasis, reduces the frequency of hemorrhage relapses and the number of emergency operations, as well as a length of hospital stay.

A prospective, randomized trial of endoscopic hemoclip placement and distilled water injection for treatment of high-risk bleeding ulcers

2003 ◽  
Vol 57 (3) ◽  
pp. 324-328 ◽  
Author(s):  
Yuh-Chyi Chou ◽  
Ping-I. Hsu ◽  
Kwok-Hung Lai ◽  
Ching-Chu Lo ◽  
Hoi-Hung Chan ◽  
...  
Keyword(s):  
High Risk ◽  
Randomized Trial ◽  
Water Injection ◽  
Prospective Randomized Trial ◽  
Distilled Water ◽  
Bleeding Ulcers
Sign in / Sign up

Export Citation Format

Share Document