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Polysaccharide hemostatic powder to prevent bleeding after endoscopic submucosal dissection in high risk patients: a randomized controlled trial
DC Field | Value | Language |
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dc.contributor.author | 박준철 | - |
dc.contributor.author | 정다현 | - |
dc.date.accessioned | 2021-12-28T16:56:53Z | - |
dc.date.available | 2021-12-28T16:56:53Z | - |
dc.date.issued | 2021-10 | - |
dc.identifier.issn | 0013-726X | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/186866 | - |
dc.description.abstract | BACKGROUND : Bleeding after endoscopic submucosal dissection (ESD) is a severe adverse event. Several methods to prevent post-ESD bleeding (PEB) have been introduced; however, they have not been widely used because of technical difficulties. We aimed to investigate whether polysaccharide hemostatic powder (PHP), which is very easy to apply, can prevent early post-ESD bleeding, especially in patients with a high risk of post-ESD bleeding. METHODS : This was a prospective, multicenter, randomized, open-label, controlled trial. Patients with a high risk for post-ESD bleeding were enrolled. Patients with gastric neoplasms in whom the resected specimen size was expected to be > 40 mm and those who were regularly taking antithrombotic agents were defined as high risk patients. Patients were randomly assigned to the PHP or control groups. RESULTS: Between May 2017 and September 2018, 143 patients were enrolled (PHP group, 73; control group, 70). The total post-ESD bleeding rate was 6.3 % (PHP group, 5.5 % vs. control group, 7.1 %; P = 0.74). There was no bleeding within 7 days after ESD in the PHP group. Continued antithrombotic use was an independent risk factor for post-ESD bleeding. In subgroup analysis excluding the patients who continued to take antithrombotic agents (n = 129) during ESD, the rate of post-ESD bleeding tended to be lower in the PHP group than in the control group (0 % vs. 6.3 %; P = 0.06). CONCLUSION : PHP did not demonstrate a significant effect on the prevention of post-ESD bleeding in this study. Further larger scale, randomized controlled trials are needed to confirm this. Trial registration: ClinicalTrials.gov NCT03169569. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Georg Thieme Verlag | - |
dc.relation.isPartOf | ENDOSCOPY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Endoscopic Mucosal Resection* / adverse effects | - |
dc.subject.MESH | Gastric Mucosa / surgery | - |
dc.subject.MESH | Hemostatics* | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Polysaccharides / therapeutic use | - |
dc.subject.MESH | Postoperative Hemorrhage / etiology | - |
dc.subject.MESH | Postoperative Hemorrhage / prevention & control | - |
dc.subject.MESH | Powders | - |
dc.subject.MESH | Prospective Studies | - |
dc.subject.MESH | Risk Factors | - |
dc.subject.MESH | Stomach Neoplasms* / surgery | - |
dc.title | Polysaccharide hemostatic powder to prevent bleeding after endoscopic submucosal dissection in high risk patients: a randomized controlled trial | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Da Hyun Jung | - |
dc.contributor.googleauthor | Hee Seok Moon | - |
dc.contributor.googleauthor | Chan Hyuk Park | - |
dc.contributor.googleauthor | Jun Chul Park | - |
dc.identifier.doi | 10.1055/a-1312-9420 | - |
dc.contributor.localId | A01676 | - |
dc.contributor.localId | A03591 | - |
dc.relation.journalcode | J00776 | - |
dc.identifier.eissn | 1438-8812 | - |
dc.identifier.pmid | 33200808 | - |
dc.identifier.url | https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-1312-9420 | - |
dc.contributor.alternativeName | Park, Jun Chul | - |
dc.contributor.affiliatedAuthor | 박준철 | - |
dc.contributor.affiliatedAuthor | 정다현 | - |
dc.citation.volume | 53 | - |
dc.citation.number | 10 | - |
dc.citation.startPage | 994 | - |
dc.citation.endPage | 1002 | - |
dc.identifier.bibliographicCitation | ENDOSCOPY, Vol.53(10) : 994-1002, 2021-10 | - |
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