Document Detail

Effects of medical adhesives in prevention of complications after endoscopic submucosal dissection.
MedLine Citation:
PMID:  23674879     Owner:  NLM     Status:  MEDLINE    
AIM: To evaluate the use of medical adhesive spray in endoscopic submucosal dissection (ESD).
METHODS: Patients who underwent ESD between January 2009 and June 2012 (n = 173) were enrolled in the prospective randomized study. Two patients undergoing surgery due to severe intraoperative hemorrhage and failed hemostasis were excluded, and the remaining 171 patients were randomly divided into two groups: group A (medical adhesive group, n = 89) and group B (control group, n = 82). In group A, a medical adhesive spray was evenly applied after routine electrocoagulation and hemostasis using hemostatic clip after ESD. Patients in group B only treated with routine wound management. Intraoperative and postoperative data were collected and compared.
RESULTS: In all 171 patients, ESD was successfully completed. There was no significant difference in the average treatment time between groups A and B (59.4 min vs 55.0 min, respectively). The average length of hospital stay was significantly different between group A and B (8.89 d vs 9.90 d, respectively). The incidence of intraoperative perforation was 10.1% in group A and 9.8% in group B, and was not significantly different between the two groups. In all cases, perforations were successfully managed endoscopically and with conservative treatment. The incidence of postoperative delayed bleeding in group A was significantly lower than that in group B (0.00% vs 4.88%, respectively).
CONCLUSION: ESD is an effective minimally invasive treatment for gastrointestinal precancerous lesions or early-stage gastrointestinal cancer. Medical adhesive spray is effective in preventing delayed bleeding after ESD, and can thus reduce the average length of hospital stay.
Yi Zhang; Ying Chen; Chun-Ying Qu; Min Zhou; Qian-Wen Ni; Lei-Ming Xu
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  19     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-15     Completed Date:  2014-01-03     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  2704-8     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Chi-Square Distribution
Dissection / adverse effects*
Endoscopy / adverse effects*
Hemostasis, Endoscopic*
Length of Stay
Middle Aged
Postoperative Hemorrhage / etiology,  prevention & control*
Prospective Studies
Time Factors
Tissue Adhesives / administration & dosage*
Treatment Outcome
Young Adult
Reg. No./Substance:
0/Aerosols; 0/Tissue Adhesives

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

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