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A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection
DC Field | Value | Language |
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dc.contributor.author | 박준철 | - |
dc.date.accessioned | 2024-01-03T00:12:21Z | - |
dc.date.available | 2024-01-03T00:12:21Z | - |
dc.date.issued | 2023-05 | - |
dc.identifier.issn | 0002-9270 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/197187 | - |
dc.description.abstract | Introduction: This study evaluated the efficacy of fibrin glue for preventing postendoscopic submucosal dissection (ESD) bleeding in high-risk patients for bleeding (expected iatrogenic ulcer size ≥40 mm or receiving antithrombotic therapy). Methods: A multicenter, open-label, randomized controlled trial was performed at 4 tertiary medical centers in South Korea between July 1, 2020, and June 22, 2022. Patients with gastric neoplasm and a high risk of post-ESD bleeding were enrolled and allocated at 1:1 to a control group (standard ESD) or a fibrin glue group (fibrin glue applied to iatrogenic ulcers after standard ESD). The primary outcome was overall bleeding events within 4 weeks. The secondary outcomes were acute bleeding (within 48 hours post-ESD) and delayed bleeding (48 hours to 4 weeks post-ESD). Results: In total, 254 patients were randomized, and 247 patients were included in the modified intention-to-treat population (125 patients in the fibrin glue group and 122 patients in the control group). Overall bleeding events occurred in 12.0% (15/125) of the fibrin glue group and 13.1% (16/122) of the control group ( P = 0.791). Acute bleeding events were significantly less common in the fibrin glue group than in the control group (1/125 vs 7/122, P = 0.034). Delayed bleeding events occurred in 11.2% (14/125) in the fibrin glue group and 7.3% (9/122) in the control group ( P = 0.301). Discussion: This trial failed to show a preventive effect of fibrin glue on overall post-ESD bleeding in high-risk patients. However, the secondary outcomes suggest a potential sealing effect of fibrin glue during the acute period. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Nature Pub. Group | - |
dc.relation.isPartOf | AMERICAN JOURNAL OF GASTROENTEROLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Endoscopic Mucosal Resection* / adverse effects | - |
dc.subject.MESH | Fibrin Tissue Adhesive / therapeutic use | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Iatrogenic Disease | - |
dc.subject.MESH | Postoperative Hemorrhage / epidemiology | - |
dc.subject.MESH | Postoperative Hemorrhage / etiology | - |
dc.subject.MESH | Postoperative Hemorrhage / prevention & control | - |
dc.subject.MESH | Stomach Neoplasms* / etiology | - |
dc.subject.MESH | Stomach Neoplasms* / surgery | - |
dc.title | A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Hyun Deok Lee | - |
dc.contributor.googleauthor | Eunwoo Lee | - |
dc.contributor.googleauthor | Sang Gyun Kim | - |
dc.contributor.googleauthor | Cheol Min Shin | - |
dc.contributor.googleauthor | Jun Chul Park | - |
dc.contributor.googleauthor | Kee Don Choi | - |
dc.contributor.googleauthor | Seokyung Hahn | - |
dc.contributor.googleauthor | Soo-Jeong Cho | - |
dc.identifier.doi | 10.14309/ajg.0000000000002172 | - |
dc.contributor.localId | A01676 | - |
dc.relation.journalcode | J00081 | - |
dc.identifier.eissn | 1572-0241 | - |
dc.identifier.pmid | 36594814 | - |
dc.identifier.url | https://journals.lww.com/ajg/fulltext/2023/05000/a_randomized_controlled_trial_of_fibrin_glue_to.26 | - |
dc.contributor.alternativeName | Park, Jun Chul | - |
dc.contributor.affiliatedAuthor | 박준철 | - |
dc.citation.volume | 118 | - |
dc.citation.number | 5 | - |
dc.citation.startPage | 892 | - |
dc.citation.endPage | 899 | - |
dc.identifier.bibliographicCitation | AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol.118(5) : 892-899, 2023-05 | - |
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