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Efficacy of Surgicel(R) (Fibrillar) for preventing bleeding after ESD for gastric epithelial tumors
Hwang JJ, Hong SJ, Han JP, Ko BM, Lee TH, Lee JS
Journal of Digestive Diseases. 2018;19((11):):657-663.
Abstract
BACKGROUND Surgicel(R) (Fibrillar), i.e., oxidized regenerated cellulose, is used to control oozing bleeding after surgery, but few studies have assessed its effect on complications after endoscopic treatment. The aim of this study was to evaluate the efficacy of Surgicel(R) for preventing bleeding after ESD for gastric epithelial tumors. METHODS From November 2012 to December 2013, patients scheduled for ESD of gastric epithelial tumors were prospectively enrolled in this study. Patients were assigned randomly to monotherapy with a PPI (MT group) or combination therapy with Surgicel(R) and H2 RA (CT group) for preventing bleeding after ESD. The major bleeding rate and changes in hemoglobin at 1 and 7 days after ESD were evaluated. RESULTS Among the 157 enrolled patients (111 males, 46 females), 78 were assigned to the MT group and 79 to the CT group. The major bleeding rate was lower in the CT group (6/74, 8.1%) than in the MT group (12/72, 16.7%), but the difference was not significant (p = 0.354). The change in hemoglobin was significantly less marked in the CT group than the MT group at 1 day after ESD (-0.62 +/- 0.90 vs. -0.89 +/- 0.62 g/dL, p = 0.045). CONCLUSIONS Combination therapy with Surgicel(R) and an H2 RA decreased the rate of bleeding similarly to PPIs. Addition of Surgicel(R) to an H2 RA could be considered for patients with bleeding tendency, or who require continuous anti-platelet therapy to prevent bleeding after ESD. This article is protected by copyright. All rights reserved.