Document Detail


Comparison of different methods for endoscopic hemostasis of bleeding canine esophageal varices.
MedLine Citation:
PMID:  6341157     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite advances in the therapy of acute esophageal variceal hemorrhage, morbidity and mortality remain high. Continued severe variceal hemorrhage remains a major clinical problem in poor risk patients who cannot tolerate emergency surgery for hemostasis. Several endoscopic hemostatic methods might be effective for variceal hemostasis, but they have not been systematically evaluated. Using a reproducible canine model of esophageal varices, several hemostatic modalities were tested and compared to determine which were most effective in stopping variceal bleeding. Methods tested were endoscopic sclerotherapy, organ laser, neodymium-yttrium-aluminum-garnet laser, monopolar electro-coagulation, bipolar electrocoagulation, ferromagnetic tamponade, and endoscopic heater probe. Both neodymium-yttrium-aluminum-garnet laser and endoscopic sclerotherapy provided reliable hemostasis in acutely bleeding canine varices. Large heater probe controlled bleeding 50% of the time, and all the other methods stopped bleeding in less than half the trials. Rebleeding after balloon inflation proximal to the coagulated bleeding site did not occur with neodymium-yttrium-aluminum-garnet laser or endoscopic sclerotherapy-treated varices but did occur with the other methods. The principal differences between neodymium-yttrium-aluminum-garnet laser and endoscopic sclerotherapy were the ease of application of neodymium-yttrium-aluminum-garnet laser, the higher frequency of esophageal ulcers or erosions with neodymium-yttrium-aluminum-garnet laser, and the lack of variceal obliteration with neodymium-yttrium-aluminum-garnet laser.
Authors:
D M Jensen; M L Silpa; J I Tapia; D B Beilin; G A Machicado
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Gastroenterology     Volume:  84     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1983 Jun 
Date Detail:
Created Date:  1983-06-10     Completed Date:  1983-06-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1455-61     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Disease Models, Animal
Dogs
Endoscopy / methods*
Esophageal and Gastric Varices / therapy*
Gastrointestinal Hemorrhage / therapy
Hemostatic Techniques*
Laser Therapy
Light Coagulation
Grant Support
ID/Acronym/Agency:
AM 17328/AM/NIADDK NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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