Document Detail


Is endoscopic band ligation superior to injection therapy for Dieulafoy lesion?
MedLine Citation:
PMID:  19125307     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dieulafoy lesion is a rare but serious cause of gastrointestinal system bleeding. An aberrant submucosal artery, which was described in 1884, causes the bleeding. The lesion can be located anywhere in the gastrointestinal tract but is most commonly found in the proximal stomach up to 6 cm from the gastroesophageal junction. Increased experience in endoscopy has led to an increased frequency of its proper diagnosis. Various methods are used to achieve successful hemostasis by endoscopy in Dieulafoy lesion; however, comparative studies about the success rates of these methods are still needed. In this study, we compared two of these endoscopic hemostatic methods: band ligation, and injection therapy in Dieulafoy lesions. METHODS: In this prospective study, 18 patients admitted to the Emergency Surgical Unit between January 2002 and December 2005 with upper gastrointestinal bleeding diagnosed as Dieulafoy lesion were included. Diagnose of Dieulafoy lesion was made at initial or second-look endoscopy. Patients were randomized in two groups according to therapy method: injection therapy and band ligation groups. Therapy was applied immediately after recognizing the lesion at the same endoscopic procedure. Two groups were compared regarding demographical data, presence of comorbid diseases, history of medication and previous gastrointestinal system bleeding, hemodynamic status, laboratory values, need for transfusion, endoscopic findings, success rate of the treatment method, mean hospital stay, complications, and recurrence of bleeding. RESULTS: Of 588 patients admitted with upper gastrointestinal hemorrhage, Dieulafoy lesion was recognized in 18 cases (3.1%) at initial or second-look endoscopy. All patients were men with a mean age of 62.8 (range, 30-80) years. Band ligation was applied to ten patients and the remaining eight were treated by injection therapy. During the follow-up period, rebleeding occurred in six of the patients (75%) with injection therapy, whereas no rebleeding occurred for the patients in the band ligation group. The rebleeding rate and mean hospital stay was significantly higher for the injection therapy group. CONCLUSIONS: Our study suggests that of the endoscopic treatment methods, band ligation is superior to injection therapy for the treatment Dieulafoy lesions.
Authors:
Halil Alis; Osman Z Oner; Mustafa U Kalayci; Kemal Dolay; Selin Kapan; Aliye Soylu; Ersan Aygun
Related Documents :
3357157 - The immediate response to injection therapy for first-degree haemorrhoids.
1088717 - Selective intraarterial infusion of vasopressin for control of gastrointestinal bleedin...
9476087 - Spacing-out of progestin--efficacy, tolerability and compliance of two regimens for hor...
20590767 - Current status of endoscopic management for nonvariceal upper gastrointestinal bleeding.
18520367 - Use of porous polyethylene implant for augmentation of the posterior pharynx in young a...
7082947 - Pyonephrosis: a critical review of 131 cases.
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-01-06
Journal Detail:
Title:  Surgical endoscopy     Volume:  23     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-15     Completed Date:  2009-10-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1465-9     Citation Subset:  IM    
Affiliation:
Department of General Surgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey. halilalis@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Arteries / abnormalities,  surgery
Cardiovascular Abnormalities / diagnosis,  therapy
Emergencies
Female
Gastrointestinal Hemorrhage / etiology,  surgery*,  therapy
Gastrointestinal Tract / blood supply
Hemostasis, Endoscopic*
Humans
Ligation / methods
Male
Middle Aged
Prospective Studies
Recurrence
Sclerotherapy

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


Previous Document:  Fungal phyllosphere communities are altered by indirect interactions among trophic levels.
Next Document:  Clinical application of laparoscopic bariatric surgery: an evidence-based review.